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一种新型冠状动脉疾病风险预测模型的开发与验证

Development and validation of a novel coronary artery disease risk prediction model.

作者信息

Wu Zu-Fei, Tao Si-Xiao, Su Wen-Tao, Chen Shi, Xu Bai-Da, Zong Gang-Jun, Wu Gang-Yong

机构信息

Department of Cardiology, Xuancheng People's Hospital, Xuanchen, Anhui, 242000, People's Republic of China.

Department of Cardiology, The 904th Hospital of the PLA Joint Logistics Support Force, Wuxi, Jiangsu, 214044, People's Republic of China.

出版信息

J Transl Med. 2025 Jan 10;23(1):41. doi: 10.1186/s12967-024-05789-1.

Abstract

OBJECTIVE

This study aims to develop a novel risk assessment tool for coronary artery disease (CAD) based on data of patients with chest pain in outpatient and emergency department, thereby facilitating the effective identification and management of high-risk patients.

METHODS

A retrospective analysis was conducted on patients hospitalized for chest pain. Patients were divided into a control group and a CAD group based on angiographic results. Logistic regression was used to identify factors associated with CAD, and R-Studio was utilized to construct the CAD risk prediction model.

RESULTS

Multivariate logistic regression analysis indicated that age, gender, diabetes, ECG (electrocardiogram) ST-T changes, neutrophils (NE), coronary artery calcification (CAC), and typical chest pain were independent factors associated with CAD. Based on the results of multifactorial logistic analysis, the CAD risk prediction model built with R-Studio had a highest C-index of 0.909, and a validation cohort C-index of 0.897, demonstrating excellent predictive ability. Decision Curve Analysis showed that the model significantly outperformed others in terms of clinical net benefit.

CONCLUSION

The present study successfully developed a CAD risk assessment model based on Chinese population. This novel model could be used to assess CAD risk in patients with chest pain, optimize clinical decision making, and improve patient outcomes, regardless of whether it is applied in large hospitals or resource-limited Community Healthcare Center.

摘要

目的

本研究旨在基于门诊和急诊科胸痛患者的数据,开发一种新型的冠状动脉疾病(CAD)风险评估工具,从而促进高危患者的有效识别和管理。

方法

对因胸痛住院的患者进行回顾性分析。根据血管造影结果将患者分为对照组和CAD组。采用逻辑回归分析确定与CAD相关的因素,并利用R-Studio构建CAD风险预测模型。

结果

多因素逻辑回归分析表明,年龄、性别、糖尿病、心电图(ECG)ST-T改变、中性粒细胞(NE)、冠状动脉钙化(CAC)和典型胸痛是与CAD相关的独立因素。基于多因素逻辑分析结果,用R-Studio构建的CAD风险预测模型的最高C指数为0.909,验证队列的C指数为0.897,显示出优异的预测能力。决策曲线分析表明,该模型在临床净效益方面显著优于其他模型。

结论

本研究成功开发了一种基于中国人群的CAD风险评估模型。这种新型模型可用于评估胸痛患者的CAD风险,优化临床决策,改善患者预后,无论其应用于大型医院还是资源有限的社区医疗中心。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd55/11720542/67635bf87c84/12967_2024_5789_Fig1_HTML.jpg

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