Establishment of an Individual Nomogram Model for Predicting the Risk of Radial Artery Stenosis or Occlusion after Transradial Artery Interventional Therapy
Objective To construct a nomogram model to predict the risk of radial artery stenosis or occlusion(RAO)after transradial artery interventional therapy.Methods A total of 254 patients who underwent transradial artery interventional therapy in our hospital from June 2019 to June 2021 were selected as the study objects,and were divided into modeling cohort(n=178)and validation cohort(n=76)according to 7:3.The patients were divided into RAO group and N-RAO group according to whether RAO occurred,and clinical data were collected;multivariate Logistic regression analysis was used to analyze the influencing factors of RAO after radial artery interventional therapy.R3.6.3 Software and rms package were used to build a nomogram model to predict the risk of RAO after transradial artery interventional therapy.Verification of nomogram internally(modeling queue)and externally(validation queue)using calibration curve and receiver operator characteristic curve(ROC curve).Results Among 178 patients who underwent radial artery interventional therapy,42 had RAO,and 136 had no RAO,with an incidence of 23.60％;the proportion of diabetes and the sheath indwelling time in RAO group were obviously higher than those in N-RAO group,and the diameter of radial artery and the amount of used heparin were obviously lower than those in N-RAO group(all P＜0.05);multivariate Logistic regression analysis showed that radial artery diameter,heparin dosage,sheath indwelling time and diabetes were all the influencing factors for RAO(all P＜0.05);the nomogram model showed that the weight of 13.8 points increased for every 0.5 mm decrease in the diameter of the radial artery;the weight of 5.1 points increased for every 10 IU/kg decrease in heparin dosage;the weight of 15.2 points increased for every 5 min increase of sheath indwelling time;the weight of 21.3 points increased for the presence of diabetes;H-L fit test showed that,x2=22.318,P=0.004,slope of calibration curve approached 1,area under ROC curve was 0.860(95％CI:0.800-0.907),sensitivity and specificity were 76.19％and 86.03％respectively,external verification x2=6.143,P=0.631,the area under the ROC curve was 0.747(95％CI:0.670-0.815),the sensitivity and specificity were 82.76％and 57.02％respectively.Conclusion Diabetes,radial artery diameter,heparin dosage and sheath indwelling time are all influencing factors of RAO after radial artery intervention.The nomogram model based on these four factors has high clinical significance in individualized prediction of the risk of RAO after radial artery intervention therapy.
Transradial artery interventional therapyRadial artery stenosis or occlusionNomogram model
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