Risk factors for poor prognosis in young and middle-aged patients with acute myocardial infarction and construction of a predictive model
10.3969/j.issn.1006-2483.2026.05.025
- VernacularTitle:中青年急性心肌梗死患者预后不良风险因素及预测模型构建
- Author:
Shuxian CAO
1
;
Chunbin WANG
1
;
Qin WANG
1
Author Information
1. Department of Cardiology, The Third People's Hospital of Chengdu, Chengdu , Sichuan 610500, China
- Publication Type:Journal Article
- Keywords:
Young and middle-aged;
Acute myocardial infarction;
Prognosis;
Risk factors;
Predictive value
- From:
Journal of Public Health and Preventive Medicine
2026;37(5):116-120
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors for poor prognosis in young and middle-aged patients with acute myocardial infarction (AMI), and to construct a prediction model for poor prognosis based on risk factors. Methods A total of 326 young and middle-aged patients with AMI admitted to Chengdu Third People's Hospital were selected between March 2023 and June 2025, and were followed up for 6 months after discharge. Based on their prognosis status, these patients were divided into a poor prognosis group (n=40) and a good prognosis group (n=286). Clinical data were collected. Univariate and multivariate logistic regression analyses were conducted to identify risk factors for poor prognosis, and a prediction model was constructed. The predictive performance of the model was evaluated using the receiver operating characteristic (ROC) curve. Results Compared with the good prognosis group, the poor prognosis group exhibited a higher proportion of hypertension, higher Global Registry of Acute Coronary Events (GRACE) scores, elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, and higher neutrophil-to-lymphocyte ratios (NLR), whereas the left ventricular ejection fraction (LVEF) was lower (P<0.05). Logistic regression analysis indicated that a high GRACE score, elevated NT-proBNP and NLR levels, and low LVEF were risk factors for poor prognosis (P<0.05). Based on these risk factors, a model was constructed as logit(P)=-18.333 + 0.086 × GRACE score + 0.005 × NT-proBNP + 0.843 × NLR - 0.083 × LVEF. The ROC curve analysis found that the area under the curve of this model in predicting poor prognosis was 0.967, which was higher than that of any single indicator used alone for prediction (z=4.431, 3.712, 3.705, 5.329, P<0.05). Conclusion GRACE score, NT-proBNP level, NLR and LVEF are risk factors influencing poor prognosis in young and middle-aged patients with AMI. The prediction model based on these factors demonstrates good predictive performance.
