Objective To analyze the influencing factors of major adverse cardiovascular events(MACE)within 6 months after primary percutaneous coronary intervention(pPCI)in patients with acute ST segment elevation myocardial infarction(STEMI),and to build a risk prediction Nomogram model.Methods The clinical data of 519 patients with acute STEMI who underwent pPCI admitted to The People's Hospital of Anyang City from June 2020 to December 2022 were retrospectively analyzed,and they were divided into a model group(n=346)and a validation group(n=173)according to the ratio of 2 : 1.The model group patients were divided into the occurrence group and the non-occurrence group based on the occurrence of MACE within 6 months after pPCI.The influencing factors of MACE within 6 months after pPCI in acute STEMI patients were screened through logistic regression analysis,and the risk prediction Nomogram model was constructed and validated.Results Killip's cardiac function class Ⅲ/Ⅳ,postoperative TIMI grade≤2 grade,no-reflow after surgery,N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),fragmented QRS wave(fQRS wave)and high-sensitivity C reactive protein(hs-CRP)were the influencing factors of MACE within 6 months after pPCI in acute STEMI patients(P<0.05).The calibration curve of the model group and the validation group showed good consistency between the calibration curve and ideal curve of the Nomogram model,and the Hosmer-Lemeshow test results for both groups were x2=2.135,P=0.977 and x2=3.756,P=0.878.The receiver operating characteristic showed that the area under the curve of the model group and validation group patients with MACE within 6 months after pPCI by the model were 0.827 and 0.811 respectively.The decision curve analysis showed that acute STEMI patients had higher net return on predicting the risk of MACE within 6 months after pPCI based on this model.Conclusion Killip's cardiac function class Ⅲ/Ⅳ,postoperative TIMI grade≤2 grade,no-reflow after surgery,NT-proBNP,LVEF,fQRS wave and hs-CRP are influencing factors for MACE within 6 months after pPCI in acute STEMI patients,and the risk prediction Nomogram model constructed based on them has good predictive efficiency and applicability,and it can be used to predict the prognosis of acute STEMI patients.
Acute ST segment elevation myocardial infarctionPrimary percutaneous coronary interventionMajor adverse cardiovascular eventsInfluence factorRisk prediction model
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