■我们旨在建立并验证临床预后列线图,以预测县级卫生服务机构中接受经皮冠状动脉介入治疗(PCI)的高危患者的长期重大不良心血管事件(MACE)。
这项前瞻性研究包括2018年9月至2019年8月在6家县级医院接受PCI治疗的急性冠状动脉综合征(ACS)患者,这些患者是从原始训练集和外部验证集中选择的。使用最小绝对收缩和选择算子(LASSO)回归技术和逻辑回归来评估潜在的风险因素并构建风险预测列线图。此外,使用受限三次样条(RCS)测试了连续变量之间的潜在非线性关系。根据接收器工作特性(ROC)曲线分析评估列线图的性能,校正曲线,决策曲线分析(DCA)和临床影响曲线(CIC)。
■原始训练集和外部验证集包括520名和1,061名患者,分别。最终的列线图是使用九个临床变量开发的:年龄,Killip功能分类III-IV,高血压,高同型半胱氨酸血症,心力衰竭,支架数量,多支血管疾病,低密度脂蛋白胆固醇,和左心室射血分数。训练集和外部验证集的列线图的AUC分别为0.79和0.75,分别。DCA和CIC验证了构建的预后列线图的临床价值。
■我们开发并验证了预测在县级医院接受PCI的ACS患者3年MACE概率的预后列线图。列线图可以为接受PCI的ACS患者的二级预防提供精确的风险评估。
UNASSIGNED: We aimed to establish and authenticate a clinical prognostic nomogram for predicting long-term Major Adverse Cardiovascular Events (MACEs) among high-risk patients who have undergone Percutaneous Coronary Intervention (PCI) in county-level health service.
UNASSIGNED: This prospective study included Acute Coronary Syndrome (
ACS) patients treated with PCI at six county-level hospitals between September 2018 and August 2019, selected from both the original training set and external validation set. Least Absolute Shrinkage and Selection Operator (LASSO) regression techniques and logistic regression were used to assess potential risk factors and construct a risk predictive nomogram. Additionally, the potential non-linear relationships between continuous variables were tested using Restricted Cubic Splines (RCS). The performance of the nomogram was evaluated based on the Receiver Operating Characteristic (ROC) curve analysis, Calibration Curve, Decision Curve Analysis (DCA), and Clinical Impact Curve (CIC).
UNASSIGNED: The original training set and external validation set comprised 520 and 1,061 patients, respectively. The final nomogram was developed using nine clinical variables: Age, Killip functional classification III-IV, Hypertension, Hyperhomocysteinemia, Heart failure, Number of stents, Multivessel disease, Low-density Lipoprotein Cholesterol, and Left Ventricular Ejection Fraction. The AUC of the nomogram was 0.79 and 0.75 in the training set and external validation set, respectively. The DCA and CIC validated the clinical value of the constructed prognostic nomogram.
UNASSIGNED: We developed and validated a prognostic nomogram for predicting the probability of 3-year MACEs in
ACS patients who underwent PCI at county-level hospitals. The nomogram could provide a precise risk assessment for secondary prevention in
ACS patients receiving PCI.