Construction of a prediction model for the risk of short-term occurrence of major adverse cardiovascular events in patients with acute decompensated heart failure based on heart failure echocardiography index and serological indicato
Construction of a prediction model for the risk of short-term occurrence of major adverse cardiovascular events in patients with acute decompensated heart failure based on heart failure echocardiography index and serological indicato
Objective To construct a predictive model for the risk of short-term occurrence of major adverse cardiovascular events(MACE)in patients with acute decompensated heart failure(ADHF)based on the heart failure echocardiography index(HFEI)and serological indicator.Methods A total of 190 ADHF patients admitted to The First Affiliated Hospital of Hainan Medical University from June 2018 to June 2021 were selected.During the follow-up period,the patients were divided into the MACE group(80 cases)and the non-MACE group(110 cases)according to whether they experienced MACE.Echocardiography was performed to measure left ventricular end-diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF),and the ratio of E-peak to A-peak of the mitral valve blood flow spectrum(E/A ratio),and the HFEI was assessed.Risk factors affecting short-term MACE in ADHF patients were analyzed by COX regression.R software was used to construct a nomogram model for predicting short-term MACE risk in ADHF patients.Results The levels of LVEDd,HFEI,uric acid,N-terminal pro-brain natriuretic peptide(NT-proBNP)and blood urea nitrogen(BUN)in the MACE group were significantly higher than those in the non-MACE group,with statistically significant difference(t=6.419,9.754,11.250,34.063,26.464;P<0.05).The E/A ratio,sodium ion level and LVEF in the MACE group were significantly lower than those in the non-MACE group(t=8.946,4.236,5.922;P<0.05).COX regression analysis showed that HFEI,uric acid and NT-proBNP were influencing factors for short-term MACE in ADHF patients(HR=1.423,1.005,1.001;P<0.05).The calibration curve of the nomogram model for predicting short-term MACE risk in ADHF patients showed good consistency,and the Hosmer-Lemeshow goodness-of-fit test indicated a good fit(χ2=7.381,P>0.05).The area under the ROC curve was 0.879(95%CI=0.830-0.928),showing good discrimination.Conclusion The nomogram model constructed in this study predicting short-term MACE risk in ADHF patients has good discrimination and consistency.
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