Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, BeiJing, People's Republic of China.
Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, People's Republic of China.
Clin Interv Aging. 2022 Jul 18;17:1099-1111. doi: 10.2147/CIA.S358761. eCollection 2022.
We aimed to develop a clinical prediction tool to improve the prognosis of major adverse cardiac and cerebrovascular events (MACCE) among high-risk myocardial infarction (MI) patients undergoing primary percutaneous coronary intervention (PCI).
The present study was a prospective and observational study. A total of 4151 consecutive MI patients who underwent primary PCI at Fuwai Hospital in Beijing, China (January 2010 and June 2017) were enrolled. Forty-eight patients without follow-up data were excluded from the study. The pre-specified criteria (Supplementary Information 1) were chosen to enroll MI patients at high risk for MACCE complications after PCI.
The full model included seven variables, with a risk score of 160 points. Derivation and validation cohort models predicting MACCE had C-statistics of 0.695 and 0.673. The area under the curve (AUC) of the survival receiver operating characteristic curve (ROC) for predicting MACCE was 0.991 and 0.883 in the derivation and validation cohorts, respectively.
The predicted model was internally validated and calibrated in large cohorts of patients with high-risk MI receiving primary PCI to predict MACCE and showed modest accuracy in the derivation and validation cohorts.
我们旨在开发一种临床预测工具，以改善接受直接经皮冠状动脉介入治疗（PCI）的高危心肌梗死（MI）患者发生主要不良心脑血管事件（MACCE）的预后。
本研究为前瞻性、观察性研究。共纳入 4151 例在北京阜外医院接受直接 PCI 的连续 MI 患者（2010 年 1 月至 2017 年 6 月）。排除 48 例无随访数据的患者。根据预设定标准（补充信息 1），选择 MI 患者接受 PCI 后发生 MACCE 并发症的高风险。
全模型包括 7 个变量，风险评分 160 分。预测 MACCE 的推导和验证队列模型的 C 统计量分别为 0.695 和 0.673。预测 MACCE 的生存接收者操作特征曲线（ROC）的曲线下面积（AUC）在推导和验证队列中分别为 0.991 和 0.883。
该预测模型在接受直接 PCI 的高危 MI 患者的大队列中进行了内部验证和校准，可预测 MACCE，在推导和验证队列中具有中等准确性。
