Value of dynamic electrocardiography combined with CT angiography for MACE in elderly patients with coronary heart disease
10.3969/j.issn.1009-0126.2025.08.012
- VernacularTitle:动态心电图联合CT血管造影对老年冠心病患者主要不良心血管事件的评估价值
- Author:
Jiawen GU
1
;
Yijun SHEN
;
Min REN
;
Beiwen ZHU
Author Information
1. 201204 上海,同济大学附属妇产科医院上海市第一妇婴保健院心电图科
- Publication Type:Journal Article
- Keywords:
coronary disease;
electrocardiography,ambulatory;
logistic models;
forecasting
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2025;27(8):1030-1035
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the value of dynamic electrocardiography(ECG)parameters combined with CT angiography(CTA)parameters in the evaluation of major adverse cardiovascu-lar events(MACE)in elderly patients with coronary heart disease(CHD).Methods A total of 110 elderly CHD patients admitted to our Hospital from January 2021 to May 2023 were prospec-tively recruited,and then divided into a MACE group(30 cases)and a non-MACE group(80 ca-ses)according to whether MACE occurred within 1 year of follow-up.The parameters of Holter,including QT interval variability(QTV),total standard deviation of N-N interval(SDNN),per-centage of total adjacent N-N over 50 ms(PNN50),and standard deviation of the average N-N in-tervals in all 5-min segment of a 24-h recording(SDANN),and the CTA parameters,such as min-imum lumen diameter(MLD),minimum lumen area(MLA),percentage of stenosis area(AS)and percentage of stenosis diameter(DS),were compared between the two groups.A nomogram-based prediction model for MACE risk was then constructed.ROC curve and calibration curve were drawn to evaluate the prediction efficiency of the risk model.Results The MACE group had significantly advanced age,more coronary lesions,and higher AS and DS values,but obviously lower SDNN,SDANN,PNN50,QTV,MLA and MLD values than the non-MACE group(P＜0.05,P＜0.01).The risk prediction model showed that advanced age,multivessel lesions,smaller SDNN,SDANN,PNN50,QTV,MLA and MLD values,and larger AS and DS values indicated higher risk of MACE in the elderly CHD patients.ROC curve analysis revealed that the AUC val-ue of our risk prediction model was 0.872(95％CI:0.764-0.975),with a sensitivity of 93.33％(28/30),a specificity of 91.25％(73/80),and an accuracy of 91.82％(101/110).Calibration curve analysis indicated that the model had a good fit(Chi-square=2.879,P=0.410),and Bootstrap in-ternal verification suggested that the model had a good accuracy(C-index=0.834).Conclusion Dynamic ECG parameters and CT A parameters are abnormal in elderly patients with MACE.Our risk prediction model based on these parameters has high value in evaluating the occurrence of MACE in the patients.
