Table 1.
MACE definitions based on publication
| Study Citation and Publication Year | Data Source and Time Period | MACE Definition | ICD-9/10 Codes Diagnosis or Procedure Position |
Validation |
|---|---|---|---|---|
| Chapman et al. (2010) [16] | IMS LifeLink: US Health Plan Claims database from 2004 to 2005 | AMI, other non-AMI IHD, HF, stroke/TIA, PVD, cardiac revascularization procedure, carotid endarterectomy |
AMI: 410.xx, 412; other non-AMI IHD: 411.xx, 413.xx, 414.xx, 427.xx, V45.81, V45.82; stroke/TIA: 433.xx, 434.xx, 435.x, 436, 437.0, 437.1, 438; PVD: 440, 440.1, 443.xx (ICD-9). (Authors did not cite ICD codes for carotid endarterectomy or other revascularization procedures.) Primary position. |
NR |
| Gudbjornsson et al. (2010) [17] | Icelandic Medicines Registry from 2001 to 2003 | AMI, UA, stroke |
AMI: I21; UA: I20.0; stroke: I63 (ICD-10). NR |
NR |
| Charlot et al. (2011) [18] | Danish national patient registry from 1997 to 2006 | AMI, stroke, CV death |
AMI: I21, I22; Stroke: I60–I69, G45 (ICD-10). (No specific codes were listed for CV death). Any position. |
Validated through data linkage between the Danish national patient registry and patient level data collected through the Danish MONICA registry [19] and the Copenhagen City Heart Study [20] |
| Kociol et al. (2011) [21] | Medicare claims linked to the ADHERE-Core registry from 2001 to 2004 | AMI, stroke |
AMI: 410.× 1; stroke: 433.x, 434.x (ICD-9). Primary position. |
NR |
| Chen et al. (2012) [22] | Taiwan National Health Research Insurance database from 2000 | AMI, ischemic stroke |
AMI: 410.xx; ischemic stroke 433.xx, 434.xx, 436, 437.1 (ICD-9). NR |
Authors cite a study validating incident events utilizing these specific ICD codes when compared with direct patient chart review [23] |
| Degli Esposti et al. (2012) [24] | Multiple databases of the Local Health Unit of Florence from 2004 to 2007 | AMI, stroke, all cause death |
AMI: 410.x; stroke: 430–438.x (ICD-9). NR |
NR |
| Parker et al. (2012) [25] | Cardiovascular Research Network Hypertension Registry from 2000 to 2009 | IHD, stroke, PVD, HF |
IHD: 410.xx–414.xx; stroke: 430.xx–434.xx, 436.xx, 852.0, 852.2. 852.4, 853.0; PVD: 441.3–441.7, 443.9, 444.0, 444.2; HF: 428.xx, 402.xx, 398.91 (ICD-9). Primary position. |
NR |
| Karthikesalingam et al. (2013) [26] | Hospital Episode Statistics data from 2006 to 2011 | AMI, stroke, aortoiliac or peripheral arterial thrombosis or embolism, emergency amputation, open/endovascular lower limb revascularization |
AMI: I21, I22; stroke: I63, I64, I69.4, I69.8 (ICD-10). NR |
NR |
| Mortensen et al. (2014) [27] | VA Health Care System administrative and clinical databases from 2001 to 2012 | AMI, HF, cardiac arrhythmia |
AMI: 410, 410.0–410.9, 411, 411.1, 412, 414.2, 414.8, 429.71, 429.79; HF: 402, 402.1, 402.10, 402.11, 402.9, 402.90, 402.91, 404, 414.19, 425.4, 428, 428.0, 428.1, 428.2, 428.20–428.23, 428.3, 428.30–428.33, 428.4, 428.40–428.43, 428.9, 429.1, 429.4, 997.1; cardiac arrhythmia: 427, 427.0, 427.1–427.5, 427.31, 427.32, 427.41, 427.42, 427.8, 427.81, 427.89, 427.9, 429.4, 997.1, V12.53 (ICD-9). NR |
NR |
| Neumann et al. (2014) [28] | Système National d’Information Inter-Régimes de l’Assurance Maladie from 2008 to 2011 | IHD, ischemic stroke |
IHD: I21–24; ischemic stroke: I63, I65, I66. (ICD-10). Any position. |
NR |
| Vanasse et al. (2014) [29] | Régie de l’assurance maladie du Québec from 2006 to 2007 | CV disease, CV death |
CV disease: 410–414, 428, 430–438 (ICD-9). I20–I25, I50, I60-I69 (ICD-10). Any position. |
NR |
| Chou et al. (2015) [30] | National Health Insurance Research Database of Taiwan from 2001 to 2010 | AMI, stroke, HF, cardiac arrhythmia, cardiac shock, cardiac revascularization procedure |
AMI: 410–410.9; stroke: 430–437; HF: 428.0–428.10, cardiac arrhythmia: 26.0, 426.12–426.13, 426.51, 426.52, 426.54, 427.1, 427.4, 427.41, 427.42, 427.5; cardiac shock: 785.51; revascularization: 36.0–36.03, 36.05–36.09, 36.1–36.99, V45.8, 36.0–36.9 (ICD-9). NR |
NR |
| Desai et al. (2015) [31] | SUPREME-DM consortium database from 2005 to 2011 | ACS, stroke, HF |
ACS: 410.0–410.9, 411.1–411.8; stroke: 430–432.9, 433–434.9; HF: 428–428.9 (ICD-9). Primary position. |
Authors cited multiple studies that have shown good PPVs using these specific ICD codes [32–34] |
| Doll et al. (2015) [35] | Medicare claims linked to the ACTION Registry-GWTG registry from 2007 to 2010 | AMI, stroke, all cause death, cardiac revascularization procedure |
AMI: 410.× 1; stroke: 430.x, 431.x, 432.x, 433.× 1, 434.× 1, 436.x, 437.1, 437.9, 997.02; revascularization: 00.66, 36.0, 36.1, 36.2, 36.3 (ICD-9). Primary position. |
NR |
| Jernberg et al. (2015) [36] | Swedish National Inpatient Register, Swedish Prescribed Drug Register, and Swedish Cause of Death Register from 2006 to 2011 | AMI, stroke, CV death |
AMI: I21; stroke: I61-I64; CV death: I00-I99 (ICD-10). NR |
Authors cited a study which reported that > 95% of MI diagnoses were valid in the National Inpatient register [37]. No validation was reported for stroke or CV death. |
| Korsnes et al. (2015) [38] | MarketScan Commercial Claims and Encounters and Medicare Supplemental Database from 2006 to 2011 | AMI, ischemic stroke |
AMI: 410.xx; ischemic stroke: 433.xx, 434.xx, 436.xx (ICD-9). Primary position. |
NR |
| Roussel et al. (2015) [39] | French National Health Insurance Information System from 2008 to 2010 | AMI, ischemic stroke, all cause death, above the ankle amputations |
AMI: I21-I24; ischemic stroke: I63, I65, I66 (ICD-10). (Authors did not use ICD codes for above the ankle amputations.) NR |
NR |
| Sirois et al. (2015) [40] | Quebec health insurance board databases, Quebec registry of hospitalization databases from 1998 to 2004 | AMI, strokes |
AMI: 410; stroke: 430–431, 433.× 1, 434.× 1 and 435 (ICD-9). Any position |
Authors cite a study that validated the accuracy of coding hospital discharge data of AMI and found a PPV of 96% utilizing this specific ICD code for AMI [41]. No validation was reported for stroke. |
| Stochkendahl et al. (2015) [42] | Danish National Patient Register from 2006 to 2011 | ACS, stroke, CV death, cardiac revascularization procedure |
ACS: I21-I23, I24.0, I24.8, I24.9; stroke: I60-I69; CV death: I00-I99 (ICD-10). (Authors did not cite ICD codes for cardiac revascularization procedures.) NR |
NR |
| Blin et al. (2016) [43] | Echantillon Généraliste des Bénéficiaires database from 2007 to 2010 | AMI, stroke/TIA, all cause death |
AMI: I21.0-I21.9, I22.0–22.9; stroke/TIA: I60-I64, G45 (ICD-10). Primary position. |
NR |
| Cheng et al. (2016) [44] | Taiwan National Health Research Insurance database from 2004 to 2015 | AMI, ischemic stroke, hemorrhagic stroke, all cause death |
AMI: 410; ischemic stroke: 434–437; hemorrhagic stroke: 430–432 (ICD-9). NR |
NR |
| Chuang et al. (2016) [45] | Taiwan National Health Research Insurance database from 1996 to 2011 | ACS, ischemic stroke, hemorrhagic stroke |
ACS: 410, 411; ischemic stroke: 433–438; hemorrhagic stroke: 430–432 (ICD-9). NR |
NR |
| Fortuna et al. (2016) [46] | HealthPartners Medical Group electronic medical record (EPIC) from 2007 to 2009 | AMI. stroke, PCI |
AMI: 410.xx; stroke: 430.xx-434.xx, 436.xx, 852.0, 852.2, 852.4, 853.0 (ICD-9); PCI: 92980–92,996 (CPT). NR |
Authors cited a study validating the claims definitions using electronic medical records [47]. |
| Hsu et al. (2016) [48] | Taiwan National Health Research Insurance database from 1995 to 2010 | AMI, stroke |
AMI: 410.x; stroke: 433.x, 434.x, 436.x (ICD-9). Primary position. |
Authors cite two studies that previously validated the accuracy of these ICD codes [49, 50]. |
| Shih et al. (2016) [51] | Taiwan National Health Insurance Research Database from 1995 to 2012 | AMI, ischemic stroke, in-hospital cardiovascular mortality |
AMI: 410.x; ischemic stroke: 433.x, 434.x, 436.x (ICD-9); in-hospital cardiovascular mortality. Primary position. |
Authors cited two studies for ischemic stroke validation only [50, 52]. |
| Solomon et al. (2016) [53] | Medicare claims linked to Brigham and Women’s Hospital electronic medical record from 2006 to 2011 | AMI, stroke, TIA |
AMI: 410.x except 410.×2; stroke: 430.x, 431.x, 434.x, 436.x; TIA: 435.x (ICD-9). NR |
Authors cited multiple studies demonstrating that using these specific ICD codes, there’s a 94% PPV for AMI, 96% PPV for stroke and 72–96% PPV for TIA [33, 54, 55]. |
| Babazade et al. (2017) [56] | Inpatient databases from multiple U.S. states, HCUP database from 2009 to 2011 | AMI, Acute coronary occlusion without AMI, postoperative pulmonary edema, cardiac arrest |
AMI: 410; acute coronary occlusion without AMI: 411.81; pulmonary edema: 518.4; cardiac arrest: 997.1 (ICD-9). NR |
NR |
| de Miguel-Yanes et al. (2017) [57] | Spanish National Hospital Discharge Database from 2002, 2006, 2010 and 2014 | AMI, stroke, aortic aneurysm and dissection, acute limb ischemia |
AMI: 410.xx; stroke: 431, 432.9, 433.× 1, 434.01, 434.11, 434.91; aortic aneurysm and dissection: 441.xx; acute limb ischemia: 440.21–440.24, 440.4, 444.22, 444.81, 445.02 (ICD-9). Primary position. |
NR |
| Lindahl et al. (2017) [58] | SWEDEHEART from 2003 to 2013 | AMI, ischemic stroke, HF, all cause death |
AMI: I21, I22, I23; ischemic stroke: I63, I64; HF: I50, K761, I971, I110 (ICD-10). NR |
NR |
| Policardo et al. (2017) [59] | Tuscany regional health system from 2008 to 2012 | AMI, ischemic stroke, HF, lower extremity amputation |
AMI: 410.xx; ischemic stroke: 430.xx, 431.xx, 432.xx, 434.xx, 436.xx; HF: 401.91, 402.01, 402.11, 402.91, 404.01, 404.3, 404.13, 404.93, 428.0, 428.1, 428.9; lower extremity amputation: 84.1x (ICD-9). NR |
NR |
| Tung et al. (2017) [60] | Taiwan National Health Research Insurance database from 2009 to 2012 | AMI, UA, stroke, resuscitation after cardiac arrest, all cause death, cardiac revascularization procedure |
AMI: 410–410.9; UA: 411.1; stroke: 430–437; resuscitation after cardiac arrest: 427.5; revascularization: 36.0–36.03, 36.05–36.09, 36.1–36.99, V45.81 (ICD-9). NR |
NR |
| Arinze et al. (2018) [61] | OptumLabs Data Warehouse from 2004 to 2014 | AMI, stroke |
AMI: 410; stroke: 434, 434.0, 434.00, 434.01, 434.1, 434.10, 434.11, 434.9, 434.90, 434.91 (ICD-9). NR |
NR |
| Baviera et al. (2018) [62] | Administrative health databases of Lombardy from 2002 to 2014 | ACS, stroke, all cause death, major amputation |
ACS: 410.xx, 411; stroke: 430, 431, 434.xx, 436, 433.11; major amputation: 84.10, 84.13, 84.14, 84.15, 84.16, 84.17, 84.18, 84.19 (ICD-9). NR |
Authors state that diagnoses were retrieved from hospital discharge charts, which have been validated across all Italian hospitals for reimbursement purposes. |
| Chan et al. (2018) [63] | Taiwan National Health Research Insurance database from 2000 to 2011 | ACS, stroke, all cause death |
ACS: 410; stroke: 430–438 (ICD-9). NR |
NR |
| Wu et al. (2018) [64] | Taiwan National Health Research Insurance database from 2001 to 2013 | AMI, stroke, HF, all cause death |
AMI: 410.xx; stroke: 430.xx-437.xx; HF: 428.xx (ICD-9). NR |
Authors cite an 88% PPV for AMI [65]. Authors do not report validation data specifically for stroke or HF. |
| Degli Esposti et al. (2018) [66] | Health-Assisted Subjects’ Database, Outpatients and Inpatients Pharmaceutical Drugs Database, Hospital Discharge Database from 2010 to 2011 (administrative databases of six Italian local health units) | AMI, other IHD, angina, cerebral artery occlusion, TIA, acute but ill-defined cerebrovascular disease |
AMI: 410; IHD: 411; angina: 413; cerebral artery occlusion: 433, 434; TIA: 435; cerebrovascular disease: 436 (ICD-9). NR |
NR |
| Hussain et al. (2018) [67] | Ontario Drug Benefit program database from 2002 to 2015 | AMI, stroke, all cause death |
AMI: I21.x, I22.x; stroke: I60.x I61.x I62.x I63.x, I64.x, H34.1, excluding I63.6 (ICD-10) NR |
Authors cite studies validating ICD codes for AMI [68] and stroke [69]. |
| Jin et al. (2018) [70] | U.S. Nationwide Readmissions Database from 2013 | AMI, HF, cardiac revascularization procedure, aortic valve repair, cardiac ablation, cardioversion, cardiac catheterization, left atrial appendage closure, Implanted cardioverter defibrillator placement, pacemaker placement, ischemic stroke, hemorrhagic stroke, iatrogenic stroke |
AMI: 410.x; HF: 428.x, 491.8, 491.9, 492.0, 492.6, 496.0; revascularization: 0.66, 36.1x, 36.2x; aortic valve repair: 35.00x, 35.01x, 35.1x, 35.2x, 35.3x, 35.05, 35.06; Cardiac ablation: 37.33, 37.34; Cardioversion 99.61, 99.62, 99.69; Cardiac catheterization: 37.21, 37.22, 37.23; Left atrial appendage closure 379, 373.6; Implanted cardioverter defibrillator placement: 37.94, 37.95, 37.96, 37.97, 37.98; pacemaker placement: 0.50, 0.51, 0.52, 0.53, 0.54, 37.7, 37.71, 37.72, 37.73, 37.74, 37.76, 37.80, 37.81, 37.82, 37.83, 37.85, 37.86, 37.87; Ischemic stroke 433.× 1, 434.× 1, 436; Hemorrhagic stroke 430, 431; Iatrogenic stroke 997.02 (ICD-9). Primary position. |
Authors cite multiple studies that have demonstrated a PPV of 89–96% using these ICD codes [55, 71, 72]. |
| Kim et al. (2018) [73] | Korean National Health Insurance Service from 2005 to 2015 | AMI, ischemic stroke, hemorrhagic stroke, HF |
AMI: I21, I22; ischemic stroke: I63, I64; hemorrhagic stroke: I60-I62; HF: I11.0, I50, I97.1 (ICD-10). NR |
NR |
| Kiss et al. (2018) [74] | National Health Insurance Fund database 2010–2013 | AMI, stroke |
AMI: I21–24; stroke: I61–63 (ICD-10). NR |
NR |
| Ohm et al. (2018) [75] | Swedish national quality registry SWEDEHEART, sub-registry SEPHIA from 2006 to 2013 | AMI, ischemic stroke, CV death |
AMI: I21.0–4, I21.9, I22.0–1, I22.8–9; ischemic stroke: I63.0–9 (ICD-10); and CV death: I46.1, I46.9. NR |
NR |
| Winell et al. (2018) [76] | National Hospital Discharge Register, National Causes of Death Register from 2000 to 2011 | ACS, ischemic stroke |
ACS: 410, 411 (ICD-9) I20.0, I21, I22 (ICD-10); stroke: 433–436, excluding 434.9x (ICD-9), I63, I64, G45 (ICD-10). NR |
Authors cite multiple studies which have validated the use of these ICD codes for this database [77, 78]. |
| Yang et al. (2018) [79] | Taiwan National Health Research Insurance database from 1996 to 2013 | AMI, ischemic stroke |
AMI: 410; ischemic stroke: 433–436 (ICD-9). NR |
NR |
| Young et al. (2018) [80] | Optum™ Integrated Real World Evidence Electronic Health Records and Claims de-identified database from 2006 to 2016 | AMI, stroke, CV death |
AMI: 410.xx (ICD-9), I21.xx, I22.xx (ICD-10); stroke: 430.xx, 431.xx, 434.xx, 436.xx (ICD-9), I60.xx, I61.xx, I63.3-I63.9, I66.xx (ICD-10); CV death (defined as death within 30 days of AMI, stroke or the following ICD codes): 411.xx-414.xx, 415.xx-417.xx, 420.xx-427.xx, 428.xx, 429.xx, 432.xx, 433.xx, 435.xx, 437.xx, 785.51 (ICD-9), I20.x, I23.xx-I25.xx, I46.9, I30.xx-I52.xx, I62.xx, I63.0-I63.2, I64.xx, I65.xx, I67.xx, I68.xx, R57.0 (ICD-10). NR |
NR |
| Arnaout et al. (2019) [81] | California Healthcare Cost and Utilization Project database from 2005 to 2009 | AMI, stroke, HF |
AMI: 410.00–410.92; stroke: 434.91, 434.11, 459.0; HF: 402.01, 402.11, 402.91, 404.91, 404,93, 425.0–425.1, 425.11, 425.18, 425.2, 425.3, 425.4, 425,5, 425.7–425.9, 428,0–428.2, 428.20–428.21, 428.22–428.23, 428.30–428.33, 428.4, 428.40–428.43, 428.9 (ICD-9). NR |
Authors cite multiple studies that have demonstrated good sensitivity and specificity for AMI, stroke and HF using these ICD codes [10–12]. |
| Chen et al. (2019) [82] | Taiwan National Health Research Insurance database from 2000 to 2008 | IHD, HF |
IHD: 410–414; HF: 428 (ICD-9). NR |
Authors cite study that validated ICD codes for AMI [65]. |
| Giral et al. (2019) [83] | Système National d’Information Inter-Régimes de l’Assurance Maladie from 2012 to 2014 | Coronary event, cerebrovascular event, other vascular event |
Coronary event: I20, I21, I22, I23, I24; cerebrovascular event: G45, G46, H34.0, H34.1, H34.2, H34.9, I60, I61, I62, I63, I64, I65, I66, I67.0; other vascular event: I70.01, I70.21, I70.81, I70.91, I71.0, I71.1, I71.3, I71.5, I71.8, I72, I74, K55.9 (ICD-10). NR |
NR |
| Hsueh et al. (2019) [84] | Taiwan National Health Research Insurance database from 2000 to 2013 | IHD, HF |
IHD: 410–414; HF: 428 (ICD-9). NR |
Authors cite study that validated ICD codes for AMI using this database [65]. |
| Kim et al. (2019) [85] | South Korean National Health Information Database from 2006 to 2014 | IHD, ischemic stroke, cardiac revascularization procedure |
IHD: I21–24; ischemic stroke: I63, I65, I66; (ICD-10). Authors did not cite ICD codes for cardiac revascularization procedures. Primary position. |
NR |
| Kuo et al. (2019) [86] | Taiwan National Health Research Insurance database from 1999 to 2010 | AMI, IHD, HF, cerebrovascular disease, all cause death |
AMI: 410, 412; IHD: 411, 413, 414, V45.81, V45.82, 00.66C, 36.0, 36.1, 36.2, 36.3, 36.9, 88.5, 37.8; HF: 428; cerebrovascular disease: 430–437, 438, V12.54, 38.11, 38.12 (ICD-9) NR |
Authors cited multiple studies that previously validated the accuracy of these ICD codes [50, 65, 87–90]. |
| Li et al. (2019) [91] | Taiwan National Health Insurance Research Database from 2000 to 2011 | CAD, HF, atrial fibrillation, stroke |
CAD: 410–414; AMI: 410; HF: 428; atrial fibrillation: 427.31; stroke: 430–438 (ICD-9). NR |
NR |
| Mureddu et al. (2019) [92] | Italian National Registry of Hospital Discharge Records (ItHDR) from 2004 to 2008, 2009–2010, 2011–2015 | AMI, stroke, all-cause death |
AMI: 410, 412; stroke: 433.×1, 434.× 1 (with the exclusion of 431, 432.x) (ICD-9). NR |
NR |
| Lin et al. (2019) [93] | Taiwan National Health Insurance Research Database from 1999 to 2011 | AMI, ischemic stroke |
AMI: 410.x; ischemic stroke: 433.x, 434.x, 436 (ICD-9). NR |
Authors cite two studies validating ICD codes for AMI and stroke using this database [50, 65]. |
| Bourrier et al. (2020) [94] | The Manitoba Health Insurance Registry, Medical Services, Discharge Abstract Database, and Diagnostic Services of Manitoba (Manitoba, Canada) from 2007 to 2014 | AMI, stroke, HF |
AMI: 410, 411, I21, I22, I23; stroke: 431, 432, 434, I61, I62, I63, I64; HF: 428, I50 (ICD-9 and 10). NR |
NR |
| Lin et al. (2020) [95] | Taiwan National Health Insurance Research Database from 2008 to 2012 | AMI, stroke, PCI, CABG, all-cause mortality. |
AMI: 410–410.9, stroke: 430–437, PCI: 36.0–36.03, 36.05–36.09; CABG: 36.1–36.99, V45.81 (ICD-9). NR |
NR |
| Madsen et al. (2020) [96] | Copenhagen General Population Study from 2003 to 2015 | AMI, CABG, PCI, stroke, CV death. |
AMI: I21-I22; CABG: NOMESCO: KNFA-KFNE; PCI: NOMESCO: KFNG00–05); stroke: I60-I61, I63-I64; CV death: I01-I87, I95-I99, R96 (ICD-10) NR |
NR |
| Petersen et al. (2020) [97] | Danish health data including the clinical laboratory information system (LABKA), the Danish National Patient Registry, the Aarhus University Prescription Database (AUPD) and the Danish Civil Registration System from 2006 to 2014. | AMI, stroke, all-cause mortality. |
AMI: I21; stroke: I61, I62, I64, I65 (ICD-10). NR |
NR |
| Seong et al. (2020) [98] | National Health Insurance Service-Elderly Cohort Database (NHIS-ECD) by the Korean National Health Insurance Service (KNHIS) from 2003 to 2008. | AMI, IHD, stroke, and CV death. |
AMI: I21-I23, I25.2; IHD: I20-I25; stroke: I63; CV death: I60-I69 (ICD-10). Any position. |
NR |
Abbreviations: NR Not reported, ICD International Classification of Diseases, CV Cardiovascular, AMI Acute myocardial infarction, IHD Ischemic heart disease, ACS Acute coronary syndrome, CAD Coronary artery disease, UA Unstable angina, PVD Peripheral vascular disease, HF Heart failure, TIA Transient ischemic attack, PCI Percutaneous coronary intervention, CABG Coronary artery bypass graft