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建立并验证了一个包含三酰甘油-葡萄糖指数和中性粒细胞与高密度脂蛋白比值的列线图模型,用于预测 ST 段抬高型心肌梗死患者的主要不良心脏事件。

Establishment and validation of a nomogram model containing a triglyceride-glucose index and neutrophil-to-high-density lipoprotein ratio for predicting major adverse cardiac events in patients with ST-segment elevation myocardial infarction.

机构信息

Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, China.

Department of Drug Research Center, Jing-dong Fang Hospital Hefei, Hefei, China.

出版信息

J Int Med Res. 2024 Sep;52(9):3000605241258181. doi: 10.1177/03000605241258181.

Abstract

OBJECTIVE

To analyze the predictive value of the triglyceride-glucose (TyG) index and neutrophil-to-high-density lipoprotein ratio (NHR) for in-hospital major adverse cardiac events (MACE) after percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI), and to establish an associated nomogram model.

METHODS

In this retrospective study, we collected data from consecutive STEMI patients who underwent PCI from October 2019 to June 2023 at the Second People's Hospital of Hefei and the Second Affiliated Hospital of Anhui Medical University, as training and validation sets. Stepwise regression and multivariate logistic regression analysis were performed to screen independent risk factors, and a nomogram model was constructed and evaluated for its predictive efficacy.

RESULTS

The TyG index, NHR, urea, diastolic blood pressure, hypertension, and left ventricular ejection fraction were independent risk factors for in-hospital MACE after PCI, and were used to construct the nomogram model. The C-index of the training and validation sets were 0.799 and 0.753, respectively, suggesting that the model discriminated well. Calibration and clinical decision curves also demonstrated that the nomogram model had good predictive power.

CONCLUSION

In STEMI patients, increased TyG index and NHR were closely related to the occurrence of in-hospital MACE after PCI. Our constructed nomogram model has some value for predicting the occurrence of in-hospital MACE in STEMI patients.

摘要

目的

分析甘油三酯-葡萄糖(TyG)指数和中性粒细胞-高密度脂蛋白比值(NHR)对急性 ST 段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后住院期间主要不良心脏事件(MACE)的预测价值,并建立相关的列线图模型。

方法

本回顾性研究纳入了 2019 年 10 月至 2023 年 6 月在合肥市第二人民医院和安徽医科大学第二附属医院接受 PCI 的连续 STEMI 患者,将其分为训练集和验证集。采用逐步回归和多因素逻辑回归分析筛选独立危险因素,并构建列线图模型并评估其预测效能。

结果

TyG 指数、NHR、尿素、舒张压、高血压和左心室射血分数是 PCI 后住院期间 MACE 的独立危险因素,用于构建列线图模型。训练集和验证集的 C 指数分别为 0.799 和 0.753,表明模型具有良好的区分能力。校准和临床决策曲线也表明该列线图模型具有良好的预测能力。

结论

在 STEMI 患者中,TyG 指数和 NHR 的增加与 PCI 后住院期间 MACE 的发生密切相关。我们构建的列线图模型对预测 STEMI 患者住院期间 MACE 的发生具有一定价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95a0/11418434/f597755de8ab/10.1177_03000605241258181-fig1.jpg

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