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Validation of the V‐RESOLVE (V isual E stimation for R isk pr E diction of S ide B ranch O cc L usion in C oronary B ifurcation inter VE ntion) score system
Author(s) -
He Yuan,
Zhang Dong,
Yin Dong,
Zhu Chen'gang,
Feng Lei,
Song Chenxi,
Chen Changzhe,
Xu Bo,
Dou Kefei
Publication year - 2018
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27499
Subject(s) - medicine , timi , occlusion , thrombolysis , confidence interval , cardiology , percutaneous coronary intervention , myocardial infarction , radiology , nuclear medicine
Objectives This study sought to validate the V‐RESOLVE score system. Background The V‐RESOLVE score was developed to predict the risk of side branch (SB) occlusion after stenting in the main vessel (MV) of coronary bifurcation lesions based on visual estimation of the angiographic data, but it needed to be validated. Methods From January to June 2013, 1,286 patients with 1,820 bifurcation lesions undergoing elective intervention with provisional strategy were included. Angiographic data before MV stenting were reviewed, and the V‐RESOLVE score was calculated. SB occlusion was defined as any decrease in thrombolysis in myocardial infarction (TIMI) flow grade or the absence of flow in the SB after MV stenting. The statistical performance of the prediction model was assessed by its discrimination, calibration, and clinical usefulness. Results SB occlusion occurred in 222 (12.20%) of 1,820 bifurcation lesions. The discrimination of the V‐RESOLVE score for the validation cohort was good [C‐statistic: 0.80, 95% confidence interval (CI) 0.77–0.84]. Regarding calibration performance, the calibration‐in‐the‐large was −0.03 (95% CI: −0.181 to 0.12), while the combined predictive effect was slightly enlarged (calibration slope: 1.25, 95% CI: 1.081–1.41) and, mainly attributed to the stronger predictive effect of the diameter stenosis of the SB before MV stenting. Stratified by the V‐RESOLVE score, the SB occlusion rate was significantly higher in the high‐risk group (26.18%) than in the non‐high‐risk group (3.48%). Conclusions The V‐RESOLVE score system is a useful tool to help risk prediction for SB occlusion and decision‐making in bifurcation intervention.