Predictive Value and Model Construction of C-reactive Protein/D-dimer Ratio and Fibrinogen/Albumin Ratio for the Occurrence of MACE after PCI in Patients with Coronary Artery Disease
10.12259/j.issn.2095-610X.S20250711
- VernacularTitle:C反应蛋白/D-二聚体比值和纤维蛋白原/白蛋白比值对冠心病患者PCI术后MACE发生的预测价值及模型构建
- Author:
Shumei QIU
1
;
Haiyan ZHANG
;
Huawei WANG
Author Information
1. 昆明医科大学第一附属医院健康管理中心,云南 昆明 650032
- Keywords:
C-reactive protein/D-dimer ratio;
Fibrinogen/albumin ratio;
Coronary heart disease;
PCI;
MACE;
Predictive model
- From:
Journal of Kunming Medical University
2025;46(7):92-100
- CountryChina
- Language:Chinese
-
Abstract:
Objective To comprehensively assess the predictive value of C-reactive protein(CRP)/D-dimer(D-D)and albumin/fibrinogen(FAR)in predicting major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in patients with coronary heart disease(CHD)and to construct a nomogram model for predicting post-procedural MACE in CHD patients.Methods A retrospective study was conducted on 201 CHD patients who underwent PCI at the First Affiliated Hospital of Kunming Medical University between June 2022 and March 2025.These patients were divided into MACE group(n=77)and non-MACE group(n=124)based on whether MACE occurred or not.84 CHD patients from another medical center were also collected as the validation set.The expression levels of CRP/D-D and FAR were compared between the two groups;independent predictors of postoperative MACE in CHD patients were screened by univariate and multivariate logistic regression analyses;the predictive value of CRP/D-D and FAR for the occurrence of postoperative MACE in CHD patients was assessed using ROC curves;A nomogram model was established integrating indicators such as CRP/D-D and FAR,and internal and external validations of the nomogram model were conducted using ROC curves,calibration curves,and decision curve analysis(DCA)curves.Results Compared with CHD patients in the non-MACE group,CRP/D-D and FAR levels were significantly higher in the MACE group(P<0.05).Multivariate analysis showed that age,NTproBNP,WBC,CRP/D-D,and FAR were independent risk factors for postoperative MACE in CHD patients(P<0.05).ROC curve analysis indicated that the AUC predicted by CRP/D-D combined with FAR was higher than that of CRP/D-D alone(Z=3.473,P<0.001),and FAR alone(Z=2.812,P<0.05).The Nomogram model constructed based on the aforementioned factors was validated internally and externally,and the results showed that the Nomogram model had good calibration,excellent discriminative ability,and reliable clinical utility,accurately predicting the risk of postoperative MACE.Conclusion The CRP/D-D ratio and FAR,as emerging composite biomarkers,showed significant predictive ability in predicting the risk of MACE after PCI in patients with CHD,providing a new reliable tool for clinical risk stratification.
