Construction of A Column-Line Diagram Model for Predicting the Risk of In-hospital Adverse Cardiovascular Events after PCI for Coro-nary Heart Disease among Elderly Patients
10.11969/j.issn.1673-548X.2025.01.013
- VernacularTitle:老年冠心病PCI术后院内不良心血管事件风险预测列线图模型构建
- Author:
Penghua YOU
1
;
Xiaojing WANG
;
Haichao CHEN
Author Information
1. 710061 西安,陕西省人民医院心血管内科
- Publication Type:Journal Article
- Keywords:
Elderly patient;
Coronary heart disease;
Percutaneous coronary intervention;
Adverse cardiovascular events;
Columnar graphic modeling
- From:
Journal of Medical Research
2025;54(1):67-72
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the impact factors on the occurrence of in-hospital adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in elderly patients with coronary heart disease(CHD),and to construct a prediction model in the form of a column-line diagram and to evaluate the effectiveness of the model.Methods The clinical data of 304 elderly coronary heart disease patients who underwent PCI from February 2021 to March 2024 in our hospital were collected.Patients were divided into MACE group(n=81)and non-MACE group(n=223)based on the occurrence of in-hospital MACE.The optimal cutoff values of each fac-tor were obtained by receiver operating characteristic(ROC)curve analysis.Logistic multiple regression modeling was used to investigate the risk factors of in-hospital MACE after PCI in elderly patients with CHD and a predictive model with columnar graphs was constructed.The correction curve was used for the internal validation of the column chart model and the decision curve was used for evaluating the pre-diction efficacy of the column chart model.Results The proportion of angina pectoris,Gensini score,the proportion of the implanted stent number＞2,and the levels of PAG,Scr,hs-CRP,Lp-PLA2 and Lp(a)were higher in the MACE group than in the non MACE group,and the difference was statistically significant(P＜0.05).The results of ROC curve analysis showed that the optimal cut-off val-ues for Gensini integral,PAG,Scr,hs-CRP,Lp-PLA2 and Lp(a)were 21 points,38.64％,96.92μmol/L,8.56mg/L,247.67μg/L and 475.14mg/L,respectively.The results of Logistic multiple regression modeling showed that the number of implanted stents,Gensi-ni score,PAG,Scr,hs-CRP,Lp-PLA2 and Lp(a)were risk factors for the occurrence of in-hospital MACE after PCI in elderly pa-tients with CHD.Internal validation shows that the C-index of the column-line graph model constructed in this study was 0.991(0.982-0.999).The observed values aligned well with the predicted values.The column-line diagram model with a threshold＞0.08 provided net clinical benefits above the number of implanted stent,Gensini score,PAG,Scr,hs-CRP,Lp-PLA2 and Lp(a).Conclu-sion In this study,the column-line graph prediction model constructed based on the number of implantated stent,Gensini score,PAG,Scr,hs-CRP,Lp-PLA2 and Lp(a)had good predictive value for the occurrence of in-hospital MACE after PCI in elderly patients with CHD,which may provide a basis for targeted clinical interventions to reduce the occurrence of in-hospital MACE.
