Establishment of a prediction model for heart failure after percutaneous coronary intervention in elderly patients with acute myocardial infarction
Objective To establish a prediction model for heart failure(HF)after percutaneous coronary intervention(PCI)in elderly patients with acute myocardial infarction(AMI).Methods A total of 326 elderly AMI patients in the First Hospital Affiliated to Harbin Medical University from January 2019 to December 2022 were retrospectively enrolled and divided into AMI-HF group(n=89)and non-AMI-HF group(n=237)based on the occurrence of HF at 6 months after surgery.Clinical materials of all the patients were collected through the electronic medical record system.Mul-tivariate Logistic regression analysis was used to screen the risk factors of AMI complicated with HF and to construct a prediction model.The performance of the prediction model was evaluated by the re-ceiver operating characteristic(ROC)curve.Results Univariate analysis showed that compared with the non-AMI-HF group,the AMI-HF group had higher proportions of patients aged over 75 years,diabetics,and higher levels of Gensini score,cardiac troponin Ⅰ(cTnⅠ),N-terminal pro-brain natriuretic peptide(NT-proBNP),blood uric acid,and high-sensitivity C-reactive protein(hs-CRP),while the left ventricular ejection fraction(LVEF)and the proportion of grade 3 of Thrombolysis in Myocardial Infarction(TIMI)blood flow were lower in the AMI-HF group,and the differences were statistically significant(P＜0.05).Multivariate Logistic regression analysis revealed that age,Gensini score,NT-proBNP,and hs-CRP were independent risk factors for HF after PCI in elderly AMI patients(P＜0.05),while TIMI grade was a protective factor(P＜0.05).After calculating the C-Index based on the screened risk factors,the ROC curve was used to evaluate the predictive a-bility of the C-Index for HF,showing an area under the curve(AUC)of 0.878(95％CI,0.834 to 0.921),with a sensitivity of 86.52％,a specificity of 75.95％,and an accuracy of 78.83％.Conclusion Age,Gensini score,NT-proBNP and hs-CRP are independent risk factors for HF after PCI in elderly AMI patients,while TIMI grade is a protective factor.The model constructed based on these factors can predict the risk of HF,thereby assisting in the early identification of high-risk HF populations and facilitating individualized interventions.
万方数据
维普
