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基于 Apelin-12 的列线图预测 ST 段抬高型心肌梗死患者经皮冠状动脉介入治疗后主要不良心血管事件。

A Nomogram Based on Apelin-12 for the Prediction of Major Adverse Cardiovascular Events after Percutaneous Coronary Intervention among Patients with ST-Segment Elevation Myocardial Infarction.

机构信息

Department of Structural Heart Disease, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.

出版信息

Cardiovasc Ther. 2020 Feb 6;2020:9416803. doi: 10.1155/2020/9416803. eCollection 2020.

Abstract

OBJECTIVE

This study aimed to establish a clinical prognostic nomogram for predicting major adverse cardiovascular events (MACEs) after primary percutaneous coronary intervention (PCI) among patients with ST-segment elevation myocardial infarction (STEMI).

METHODS

Information on 464 patients with STEMI who performed PCI procedures was included. After removing patients with incomplete clinical information, a total of 460 patients followed for 2.5 years were randomly divided into evaluation ( = 324) and validation ( = 324) and validation (.

RESULTS

Apelin-12 change rate, apelin-12 level, age, pathological Q wave, myocardial infarction history, anterior wall myocardial infarction, Killip's classification > I, uric acid, total cholesterol, cTnI, and the left atrial diameter were independently associated with MACEs (all < 0.05). After incorporating these 11 factors, the nomogram achieved good concordance indexes of 0.758 (95%CI = 0.707-0.809) and 0.763 (95%CI = 0.689-0.837) in predicting MACEs in the evaluation and validation cohorts, respectively, and had well-fitted calibration curves. The decision curve analysis (DCA) revealed that the nomogram was clinically useful.

CONCLUSIONS

We established and validated a novel nomogram that can provide individual prediction of MACEs for patients with STEMI after PCI procedures in a Chinese population. This practical prognostic nomogram may help clinicians in decision making and enable a more accurate risk assessment.

摘要

目的

本研究旨在建立一种临床预后列线图,用于预测 ST 段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后主要不良心血管事件(MACE)。

方法

纳入 464 例行 PCI 治疗的 STEMI 患者的信息。在去除临床信息不完整的患者后,共有 460 例患者随访 2.5 年,随机分为评估(n=324)和验证(n=324)组。

结果

Apelin-12 变化率、Apelin-12 水平、年龄、病理性 Q 波、心肌梗死史、前壁心肌梗死、Killip 分级> I、尿酸、总胆固醇、cTnI 和左心房直径与 MACE 独立相关(均 P<0.05)。纳入这 11 个因素后,该列线图在评估和验证队列中预测 MACE 的一致性指数分别为 0.758(95%CI=0.707-0.809)和 0.763(95%CI=0.689-0.837),且校准曲线拟合良好。决策曲线分析(DCA)显示该列线图具有临床应用价值。

结论

我们建立并验证了一种适用于中国人群的新列线图,可对行 PCI 治疗的 STEMI 患者进行 MACE 的个体化预测。这种实用的预后列线图有助于临床医生进行决策,并实现更准确的风险评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e258/7026703/0f297679fc9f/CDTP2020-9416803.001.jpg

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