Establishment and validation of a risk prediction model for clinical outcomes after percutaneous coronary intervention in patients with acute coronary syndrome and diabetes
Establishment and validation of a risk prediction model for clinical outcomes after percutaneous coronary intervention in patients with acute coronary syndrome and diabetes
Objective To develop a risk prediction model for predicting the occurrence of the major adverse cardiovascular events(MACE)in patients with acute coronary syndrome and diabetes after percutaneous coronary intervention.Methods A total of 672 patients with acute coronary syndrome and diabetes admitted to the Cardiovascular Department of Shengjing Hospital,China Medical University between May 2018 and December 2020 were selected and divided into modeling group(75%)and validation group(25%)with systematic sampling method.Clinical data were collected retrospectively.The clinical characteristics and serum biomarkers were used for further analyses by LASSO regression analysis to identify the potential risk factors and by logistic regression analysis to identify the independent risk factors for the predictive modelling.The area under the subject operating characteristic curve was used to assess the discriminatory power of the model;calibration curves were used for calibration of the model;and decision curve analysis was used to assess the clinical validity of the model.Results MACE occurred in 122 patients(18.15%),including 82(16.27%)and 40(23.81%)in the modelling and validation group,respectively.Five variables,including the age,left ventricular ejection fraction,stent placement,triglyceride-glucose index and vessel stenosis,number were identified to construct the model,and the values of the area under the curve of the working characteristics of the subjects in the modelling and validation group were 0.812 and 0.803,respectively,which demonstrated that the model had a very good discriminatory power.In addition,calibration and decision curve analyses indicated that the model had high accuracy and clinical value,respectively.Conclusions Age,left ventricular ejection fraction,stent placement,triglyceride-glucose index,and vessel stenosis are independent risk factors associated with adverse cardiovascular events in patients with acute coronary syndromes combined with diabetes who undergo coronary intervention.This model may guide secondary prevention therapy for the patients and facilitate early intervention to prevent adverse cardiovascular events and improve patient prognosis.
关键词
经皮冠状动脉介入治疗/急性冠状动脉综合征/糖尿病/不良心血管事件/风险模型
Key words
Percutaneous coronary intervention/Acute coronary syndrome/Diabetes/Adverse cardiovascular events/Risk model
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