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预测急性冠状动脉综合征后女性新发心力衰竭发生率的列线图。

Nomogram to predict the incidence of new-onset heart failure after acute coronary syndrome among women.

作者信息

Yan Qiqi, Ye Lifang, Zhang Qinggang, Song Jikai, Zhang Xin, Wu Liuyang, Wang Lihong

机构信息

Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China.

The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China.

出版信息

Front Cardiovasc Med. 2023 Mar 24;10:1131813. doi: 10.3389/fcvm.2023.1131813. eCollection 2023.

Abstract

BACKGROUND

Although great progress has been made in caring for patients with acute coronary syndrome (ACS), the incidence of heart failure (HF) after discharge remains high after ACS.

AIMS

We aimed to investigate the risk predictors for new-onset HF and build a simple nomogram to optimize the clinical management of female patients.

METHODS

The clinical data of 319 female patients with ACS between January 1, 2021 and January 1, 2022, were obtained from the Zhejiang Provincial People's Hospital. Multivariate logistic regression analysis was carried out to build the prediction model among all participants and then verified by 10-fold cross-validation. The discrimination, calibration, and clinical usefulness of the prediction model were assessed using receiver operating characteristic curve, calibration curve, and decision curve analyses.

RESULTS

This study analyzed 15 potential independent risk predictors of new-onset HF in 319 female patients with ACS. The incidence of HF onset was 23.2%. The following 5 independent risk predictors were filtered out as most relevant for predicting 12-month HF onset: left ventricular ejection fraction ≤ 60.5%, high-density lipoprotein ≤ 1.055 mmol/L, human epididymal protein 4 > 69.6 pmol/L, creatinine > 71.95 µmol/L, and diagnosis of myocardial infarction (MI).

CONCLUSION

Our nomogram, which used five easily obtained clinical variables, could be a useful tool to help identify female individuals with ACS who are at high risk of developing HF after discharge and facilitate communication between female patients and physicians.

摘要

背景

尽管在急性冠状动脉综合征(ACS)患者的护理方面取得了巨大进展,但ACS后出院后心力衰竭(HF)的发生率仍然很高。

目的

我们旨在研究新发HF的风险预测因素,并构建一个简单的列线图以优化女性患者的临床管理。

方法

从浙江省人民医院获取了2021年1月1日至2022年1月1日期间319例女性ACS患者的临床数据。对所有参与者进行多因素逻辑回归分析以建立预测模型,然后通过10倍交叉验证进行验证。使用受试者工作特征曲线、校准曲线和决策曲线分析评估预测模型的辨别力、校准度和临床实用性。

结果

本研究分析了319例女性ACS患者中15个潜在的新发HF独立风险预测因素。HF发病的发生率为23.2%。筛选出以下5个与预测12个月HF发病最相关的独立风险预测因素:左心室射血分数≤60.5%、高密度脂蛋白≤1.055 mmol/L、人附睾蛋白4>69.6 pmol/L、肌酐>71.95 µmol/L以及心肌梗死(MI)诊断。

结论

我们的列线图使用了五个易于获得的临床变量,可能是一个有用的工具,有助于识别出院后发生HF风险高的女性ACS患者,并促进女性患者与医生之间的沟通。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c06d/10080589/4716c1bd5e01/fcvm-10-1131813-g001.jpg

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