Zhang Jie, Liu Mengyu, Gao Ju, Tian Xiaowen, Song Yaru, Zhang Haibei, Zhao Peng
Department of Clinical Nutrition, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
Department of Clinical Nutrition, Shandong Provincial Hospital, Shandong University, Jinan, 250012, Shandong, China.
Sci Rep. 2025 Jan 6;15(1):996. doi: 10.1038/s41598-024-84092-x.
Percutaneous coronary intervention (PCI) is a practical and effective method for treating coronary heart disease (CHD). This study aims to explore the influencing factors of major cardiovascular events (MACEs) and hospital readmission risk within one year following PCI treatment. Additionally, it seeks to assess the clinical value of Apolipoprotein B/Apolipoprotein A-I (ApoB/ApoA-I) in predicting the risk of one-year MACEs and readmission post-PCI. A retrospective study included 1938 patients who underwent PCI treatment from January 2010 to December 2018 at Shandong Provincial Hospital affiliated with Shandong First Medical University. Patient demographics, medications, and biochemical indicators were recorded upon admission, with one-year follow-up post-operation. Univariate and multivariate Cox proportional hazards regression models were utilized to establish the relationship between ApoB/ApoA-I levels and MACEs/readmission. Predictive nomograms were constructed to forecast MACEs and readmission, with the accuracy of the nomograms assessed using the concordance index. Subgroup analyses were conducted to explore the occurrence of MACEs and readmission. We observed a correlation between ApoB/ApoA-I and other lipid indices, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) (P < 0.001). Univariate and multivariate Cox regression analyses demonstrated that ApoB/ApoA-I is an independent risk factor for MACEs in post-PCI patients (P = 0.038). Within one year, the incidence of MACEs significantly increased in the high-level ApoB/ApoA-I group (ApoB/ApoA-I ratio ≥ 0.824) (P = 0.038), while the increase in readmission incidence within one year was not statistically significant. Furthermore, a nomogram predicting one-year MACEs was established (Concordance Index: 0.668). Subgroup analysis revealed that ApoB/ApoA-I was associated with the occurrence of both MACEs and readmission in male patients, those using CCB/ARB/ACEI, those without multivessel diseases, or those with LDL-C < 2.6 mmol/L. The ApoB/ApoA-I ratio serves as an independent risk factor for one-year MACEs in post-PCI patients and correlates closely with other blood lipid indicators. ApoB/ApoA-I demonstrates significant predictive value for the occurrence of MACEs within one year.Trial registration Chinese clinical trial registry: No.ChiCTR22000597-23.
经皮冠状动脉介入治疗(PCI)是治疗冠心病(CHD)的一种实用且有效的方法。本研究旨在探讨PCI治疗后一年内主要心血管事件(MACE)的影响因素及再次入院风险。此外,本研究旨在评估载脂蛋白B/载脂蛋白A-I(ApoB/ApoA-I)在预测PCI术后一年内发生MACE和再次入院风险中的临床价值。一项回顾性研究纳入了2010年1月至2018年12月在山东第一医科大学附属山东省立医院接受PCI治疗的1938例患者。记录患者入院时的人口统计学资料、用药情况和生化指标,并在术后进行一年的随访。采用单因素和多因素Cox比例风险回归模型来确定ApoB/ApoA-I水平与MACE/再次入院之间的关系。构建预测MACE和再次入院的列线图,并使用一致性指数评估列线图的准确性。进行亚组分析以探讨MACE和再次入院的发生情况。我们观察到ApoB/ApoA-I与其他血脂指标之间存在相关性,包括总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)(P<0.001)。单因素和多因素Cox回归分析表明,ApoB/ApoA-I是PCI术后患者发生MACE的独立危险因素(P = 0.038)。在一年内,ApoB/ApoA-I高水平组(ApoB/ApoA-I比值≥0.824)的MACE发生率显著增加(P = 0.038),而一年内再次入院发生率的增加无统计学意义。此外,建立了一个预测一年内MACE的列线图(一致性指数:0.668)。亚组分析显示,ApoB/ApoA-I与男性患者、使用CCB/ARB/ACEI的患者、无多支血管病变的患者或LDL-C<2.6 mmol/L的患者发生MACE和再次入院均相关。ApoB/ApoA-I比值是PCI术后患者一年内发生MACE的独立危险因素,且与其他血脂指标密切相关。ApoB/ApoA-I对一年内MACE的发生具有显著的预测价值。试验注册 中国临床试验注册中心:No.ChiCTR22000597 - 23。