Risk factors and construction of prediction model of early malignant ventricular arrhythmia in patients with acute myocardial infarction
10.3969/j.issn.1006-2483.2025.06.029
- VernacularTitle:急性心肌梗死患者早期恶性室性心律失常的危险因素分析及预测模型构建
- Author:
Xuling GAO
1
;
Shengzhen YANG
2
;
Mingkai YAO
1
;
Yan LYU
3
Author Information
1. Second Department of Cardiovascular Medicine,Jiaozhou Central Hospital of Qingdao, Qingdao , Shandong 266300, China
2. Department of Thoracic Surgery,Jiaozhou Central Hospital of Qingdao, Qingdao , Shandong 266300, China
3. Department of Endocrinology and Hematology, Jiaozhou Central Hospital of Qingdao, Qingdao , Shandong 266300, China
- Publication Type:Journal Article
- Keywords:
Acute myocardial infarction;
Malignant ventricular arrhythmia;
Killip grading;
Risk factors;
Prediction model
- From:
Journal of Public Health and Preventive Medicine
2025;36(6):127-131
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the incidence rate and predictors of early(≤48 h) malignant ventricular arrhythmia (MVA) in patients with acute myocardial infarction (AMI), and to establish and validate a clinical prediction model to assist in identifying high-risk patients. Methods The clinical data of 278 patients with AMI in the hospital from February 2023 to February 2025 were retrospectively analyzed. Based on MVA occurrence within 48 hours post-AMI, patients were divided into the MVA group (n=225 cases) and non-MVA group (n=53 cases).. The clinical data in the two groups were collected, and the predictive variables were determined by univariate Logistic analysis and multivariate Logistic regression analysis to establish a prediction model for MVA. Results The proportion of patients with Killip grade III or IV in MVA group was higher than that in non-MVA group (P<0.05), and the levels of white blood cell count (WBC), creatine kinase isoenzyme (CKMB) and troponin I (TnI) were also higher than those in non-MVA group (P<0.05) while the standard deviation of normal to normal RR intervals (SDNN) and left ventricular ejection fraction (LVEF) were lower than those in non-MVA group (P<0.05). Multivariate Logistic regression analysis showed that Killip grade≥III, high levels of WBC, CKMB and TnI and low SDNN and LVEF were independent risk factors of early MVA in patients with AMI (P<0.05). Based on the above six factors, a risk nomogram prediction model was constructed, and the model verification results showed that the area under the ROC curve (AUC) was 0.884 (95%CI: 0.835-0.932), with good model discrimination. The calibration curve was close to the ideal curve (Hosmer-Lemeshoe P=0.768), and the model had good predictive efficiency. The decision curve showed that the model had a higher predicted net benefit value (threshold=0.1-0.97). Conclusion Cardiac function Killip grade≥III, high WBC, CKMB and TnI and low SDNN and LVEF are independent risk factors of early MVA in AMI patients. The clinical prediction model based on the above variables has certain predictive value on the risk of MVA in AMI patients.
