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ST段抬高型心肌梗死患者直接经皮冠状动脉介入治疗后缺血性二尖瓣反流的列线图风险预测模型

A nomogram risk prediction model for ischemic mitral regurgitation after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction.

作者信息

Ye Jiangping, Yuan Rikang, Liu Yehong, Wang Weijian, Xu Dongxia, Li Yimeng, Wu Gangyong, Zong Gangjun

机构信息

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

Department of Emergency Medicine, Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, People's Republic of China.

出版信息

Eur J Med Res. 2025 May 3;30(1):357. doi: 10.1186/s40001-025-02624-1.

Abstract

AIM

This study developed a nomogram to predict the risk of ischemic mitral regurgitation (IMR) after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) patients and evaluate their long-term prognosis.

METHODS

Data from 342 STEMI patients were collected. Logistic regression identified independent risk factors for IMR during hospitalization, while Cox regression assessed risk factors during follow-up. The nomogram was developed based on these factors. ROC evaluated its predictive value, and decision curve analysis/clinical impact curves assessed clinical utility. Kaplan-Meier analysis evaluated the model's prognostic value.

RESULTS

The independent risk factors for hospitalized IMR after PCI in STEMI patients included Gensini score (OR 1.009; P = 0.047), left ventricular ejection fraction (LVEF) (OR 0.941; P = 0.007), albumin (OR 0.941; P = 0.046), and systemic immune-inflammatory index (SII) (OR 1.096; P < 0.001). During follow-up, diabetes mellitus (HR: 1.154; P = 0.019), hemoglobin (HR: 0.991; P = 0.028), Gensini score (HR: 1.007; P = 0.022), LVEF (HR: 0.972; P = 0.015), and SII/100 (HR: 1.034; P < 0.001) were identified as independent predictors of IMR. The nomogram showed strong clinical benefit, good calibration, and predictive value. Patients with lower scores had better long-term outcomes.

CONCLUSION

This nomogram effectively predicts the occurrence of IMR after PCI in STEMI patients, providing valuable prognostic insights.

摘要

目的

本研究构建了一种列线图,用于预测ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后发生缺血性二尖瓣反流(IMR)的风险,并评估其长期预后。

方法

收集了342例STEMI患者的数据。逻辑回归确定了住院期间IMR的独立危险因素,而Cox回归评估了随访期间的危险因素。基于这些因素构建了列线图。ROC评估其预测价值,决策曲线分析/临床影响曲线评估临床实用性。Kaplan-Meier分析评估了该模型的预后价值。

结果

STEMI患者PCI后住院期间IMR的独立危险因素包括Gensini评分(OR 1.009;P = 0.047)、左心室射血分数(LVEF)(OR 0.941;P = 0.007)、白蛋白(OR 0.941;P = 0.046)和全身免疫炎症指数(SII)(OR 1.096;P < 0.001)。在随访期间,糖尿病(HR:1.154;P = 0.019)、血红蛋白(HR:0.991;P = 0.028)、Gensini评分(HR:1.007;P = 0.022)、LVEF(HR:0.972;P = 0.015)和SII/100(HR:1.034;P < 0.001)被确定为IMR的独立预测因素。该列线图显示出强大的临床益处、良好的校准度和预测价值。得分较低的患者长期预后较好。

结论

该列线图可有效预测STEMI患者PCI后IMR的发生,提供有价值的预后见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93fb/12048939/dc8476a5c1b0/40001_2025_2624_Fig1_HTML.jpg

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