Naman Tuersunjiang, Abuduhalike Refukaiti, Abudouwayiti Aihaidan, Sun Juan, Mahemuti Ailiman
Department of Heart Failure, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China.
Int J Gen Med. 2023 Sep 6;16:4051-4066. doi: 10.2147/IJGM.S425872. eCollection 2023.
This study investigated the correlation between polymorphisms of the gene and prognosis of Ischemic cardiomyopathy (ICM), and developed a prognostic model for predicting the prognosis ICM on the basis of gene variants.
The current study included totally 576 patients with ICM. All patients are randomly divided into training group with 399 patients and validation group with 177 patients. The prognostic model was constructed by using the data of training group. Univariable Cox-regression analysis was performed, including clinical and gene variants, then used the least absolute shrinkage and selection operator (LASSO) regression model to optimize feature selection. Furthermore, multivariate Cox-regression was applied to build the prognostic nomogram model, which included clinical and gene features chosen by the LASSO regression model. Following that, the receiver operating characteristic (ROC) curve, C-index, calibration plot analyses and decision curve analysis (DCA) were carried out to evaluate the discrimination ability, consistency, and clinical utility of the prognostic model.
Predicting factors rs281430, ventricular arrhythmia, treating by PCI or CABG, use of β-blockers, heart rate (HR), serum sodium level, left ventricular end-diastolic diameter (LVDD) were the risk factors of the prognosis of ICM, incorporated these factors into the prognostic nomogram model. The constructed nomogram performed well in discrimination ability, as observed by the ROC and C-index. Furthermore, as shown by calibration curves, our nomogram's predicted probabilities were highly consistent with measured values. With threshold probabilities, DCA suggested that our nomogram could be useful in the clinic.
rs281430 mutation (from AA genotype to AG or GG genotype) is a risk factor for ICM patients to have a higher survival probability; the survival probability of ICM patients with the mutant genotype (AG or GG) is lower than those with the wild genotype (AA).
本研究探讨该基因多态性与缺血性心肌病（ICM）预后的相关性，并基于基因变异建立预测ICM预后的模型。
本研究共纳入576例ICM患者。所有患者随机分为训练组399例和验证组177例。利用训练组数据构建预后模型。进行单变量Cox回归分析，包括临床和基因变异，然后使用最小绝对收缩和选择算子（LASSO）回归模型优化特征选择。此外，应用多变量Cox回归构建预后列线图模型，该模型包括LASSO回归模型选择的临床和基因特征。随后，进行受试者工作特征（ROC）曲线、C指数、校准图分析和决策曲线分析（DCA），以评估预后模型的辨别能力、一致性和临床实用性。
预测因素rs281430、室性心律失常、接受PCI或CABG治疗、使用β受体阻滞剂、心率（HR）、血清钠水平、左心室舒张末期直径（LVDD）是ICM预后的危险因素，并将这些因素纳入预后列线图模型。如ROC和C指数所示，构建的列线图在辨别能力方面表现良好。此外，校准曲线显示，我们的列线图预测概率与测量值高度一致。根据阈值概率，DCA表明我们的列线图在临床上可能有用。
rs281430突变（从AA基因型变为AG或GG基因型）是ICM患者生存概率较高的危险因素；突变基因型（AG或GG）的ICM患者生存概率低于野生基因型（AA）的患者。
