Department of Structural Heart Disease, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
Cardiovasc Ther. 2020 Feb 6;2020:9416803. doi: 10.1155/2020/9416803. eCollection 2020.
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).
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 (.
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.
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.
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)。
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。
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。
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。