Prediction‎ > ‎

Kyoto model

PCIまたはCABGによる冠動脈再建後の予後を予測するWEBアプリです.    >> Click for Use! 



初めて利用される方へ
  • 死亡率, 二回目の冠動脈再建術施行の確率を計算します. 
  • 個々の患者さんの特徴・併存疾患に基づいて, 術後30日, 6ヶ月, 1, 2, 3年時点の予測が可能です. 
  • 略語は以下の通りです. 
    • BMI: ボディーマスインデックス
    1. PVD: 末梢血管疾患
    2. COPD: 慢性閉塞性肺疾患
    3. CKD: 慢性腎疾患. 
  • 初回の冠動脈再建術を対象とします. 急性心筋梗塞後の手術や, 別の心血管合併手術を含む場合は, 利用できません. 
  • CREDO-Kyotoレジストリに参加された患者さん9,393人のデータより構築されました. 参加された方々に感謝いたします. 
  • ただし, シロリムス溶解性ステント使用時の予後予測には, 一部に海外のメタアナリシスのデータを利用しています. 

ソフトウェア情報
  • β Version 1.1です(2010/3/19現在). 
  • Kyoto modelはフリーソフトウェアですが, 著作権はCREDO-Kyoto Registryの研究者が保有します. リンクは自由に行って頂いて構いませんが, 手数料を徴収したり使用に制限を付けることは禁じます. また, SWFファイルを改変することも禁じます.
  • Kyoto 
    modelの使用によって生じた, いかなる損害についてもCREDO-Kyoto Registryの研究者は保証する義務を負いかねます. 
謝辞
全面的な支援を頂きました木村剛先生, 坂田隆造先生, 丸井晃先生に感謝いたします. 



Details for clinicians

Target
The Kyoto model targets patients who undergo their first coronary revascularization except for (i) patients with acute myocardial infarction within one week after onset or (ii) patients receiving concomitant valvular, left ventricular, or major vascular operation. 

Definition
Abbreviation is as follows; BMI: body mass index; PVD: peripheral vascular disease; COPD: chronic pulmonary disease; CKD: Chronic kidney disease. Stroke includes asymptomatic stroke detected by noninvasive imaging modalities. Peripheral vascular disease is regarded to be present when carotid, aortic, or other peripheral vascular disease were being treated or scheduled for surgical or endovascular interventions. Chronic kidney disease is regarded as present when creatinine clearance estimated by Cockcloft-Gould formula was less than 60 mL/min. Anemia was defined as blood hemoglobin level less than 12 g/dL. 

Data
The Kyoto 
model was developed and validated using data of 9,393 patients in the CREDO-Kyoto Registry, a nationwide observational study of 30 institutes in Japan. See “Long-Term Outcomes of Coronary-Artery Bypass Graft Surgery Versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease in the Bare-Metal Stent Era.” in Circulation 2008 by Kimura, et al. Since most of the patients in the CREDO-Kyoto Registry used bare-metal stents and sirolimus-eluting stent (SES) did not used, we used data from "5-Year Clinical Outcomes After Sirolimus-Eluting Stent Implantation." in Journal of the American College of Cardiology 2010 by Caixeta et al. That is, we assumed that SES reduces hazard of revascularization by 9.3/25.3 times before one year after first revascularization and increases hazard by 2.4/2.1 times between one year and five years. Mortality is supposed to increase by 1.3/0.8 times before one year after first revascularization if SES is used, but the same as bare-metal stents thereafter. Prediction of outcomes after SES implantation has not been validated. 

Software information
The Kyoto 
model Ver. 1.1 Beta, released on 19 MAR 2010. Statistical analysis and programming by Shiro Tanaka. Copyright (c) 2010 by the CREDO-Kyoto Registry investigators. All Rights Reserved. 

Comments