1. A Multicenter External Validation of a Score Model to Predict Risk of Events in Patients With Brugada Syndrome.
- Author
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Chow JJ, Leong KMW, Yazdani M, Huzaien HW, Jones S, Shun-Shin MJ, Koa-Wing M, Lefroy DC, Lim PB, Linton NWF, Ng FS, Qureshi NA, Whinnett ZI, Peters NS, O'Callaghan P, Yousef Z, Kanagaratnam P, and Varnava AM
- Subjects
- Brugada Syndrome complications, Brugada Syndrome physiopathology, Death, Sudden, Cardiac etiology, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable, Electrophysiologic Techniques, Cardiac, Female, Humans, Male, Middle Aged, Reproducibility of Results, Risk Assessment, Sick Sinus Syndrome physiopathology, Syncope physiopathology, United Kingdom epidemiology, Brugada Syndrome therapy, Death, Sudden, Cardiac epidemiology
- Abstract
A multivariate risk score model was proposed by Sieira et al in 2017 for sudden death in Brugada syndrome; their validation in 150 patients was highly encouraging, with a C-index of 0.81; however, this score is yet to be validated by an independent group. A total of 192 records of patients with Brugada syndrome were collected from 2 centers in the United Kingdom and retrospectively scored according to a score model by Sieira et al. Data were compiled summatively over follow-up to mimic regular risk re-evaluation as per current guidelines. Sudden cardiac death survivor data were considered perievent to ascertain the utility of the score before cardiac arrest. Scores were compared with actual outcomes. Sensitivity in our cohort was 22.7%, specificity was 57.6%, and C-index was 0.58. In conclusion, up to 75% of cardiac arrest survivors in this cohort would not have been offered a defibrillator if evaluated before their event. This casts doubt on the utility of the score model for primary prevention of sudden death. Inherent issues with modern risk scoring strategies decrease the likelihood of success even in robustly designed tools such as the Sieira score model., Competing Interests: Disclosures The authors have no conflicts of interest to disclose., (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Published
- 2021
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