| 闫广有,齐贺文,高景芳.老年AMI患者PCI术后新发心力衰竭风险预测模型的构建.[J].中南医学科学杂志.,2025,(6):1011-1014. |
| 老年AMI患者PCI术后新发心力衰竭风险预测模型的构建 |
| Risk prediction model for new-onset heart failure in elderly patients with AMI after PCI |
| 投稿时间：2025-01-07 修订日期：2025-09-25 |
| DOI：10.15972/j.cnki.43-1509/r.2025.06.017 |
| 中文关键词: AMI 预后营养指数 PCI 新发心力衰竭 预测模型 |
| 英文关键词:AMI prognostic nutritional index PCI new-onset heart failure prediction model |
| 基金项目:河北省医学科学研究计划项目(20191565) |
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| 中文摘要: |
| 目的构建预测老年急性心肌梗死(AMI)患者行经皮冠状动脉介入治疗(PCI)后新发心力衰竭的模型,并评估其有效性。 方法回顾性选择因AMI接受PCI的老年患者193例,根据是否出现新发心力衰竭分为对照组(n＝139)及心力衰竭组(n＝54)。收集两组患者临床基线特征、共患病史、既往病史、实验室指标与治疗结果。通过Stepwise逐步回归筛选与新发心力衰竭相关的变量,采用多因素Logistic回归分析新发心力衰竭的影响因素,并构建预测列线图。通过受试者工作特征(ROC)曲线和决策曲线分析(DCA)对模型的预测能力进行评估。 结果与对照组相比,心力衰竭组年龄更大,合并原发性高血压占比、既往心肌梗死占比、左主干病变占比和心肌肌钙蛋白I(c-TnI)水平较高；而预后营养指数(PNI)水平更低(P＜0.05)。年龄、原发性高血压、既往心肌梗死、左主干病变是新发心力衰竭的危险因素；PNI是新发心力衰竭的保护因素(P＜0.05),并成功构建了预测老年AMI患者PCI后新发心力衰竭的列线图模型,该模型预测能力良好,模型预测值与实际观察值具有高度拟合和一致性,该模型在临床应用中展现了良好的净获益。 结论该预测模型可用于初步评估老年AMI患者PCI后新发心力衰竭的风险,帮助早期识别高风险患者,并制定个性化的治疗方案。 |
| 英文摘要: |
| AimTo develop and validate a prediction model for new-onset heart failure in elderly patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). MethodsA retrospective study included 193 elderly AMI patients who underwent PCI. Patients were divided into a control group (n＝139) and a heart failure group (n＝54) based on the occurrence of new-onset heart failure. Clinical baseline characteristics, comorbidities, medical history, laboratory indicators, and treatment outcomes were collected from both groups. Stepwise regression was used to screen variables associated with new-onset heart failure, and multivariate Logistic regression analysis was employed to identify influencing factors and construct a predictive nomogram.The model's predictive performance was evaluated using receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA). ResultsCompared with the control group, the heart failure group had higher age, greater proportions of hypertension, previous myocardial infarction, left main coronary artery disease, and higher cardiac troponin I (c-TNI) levels, while the prognostic nutritional index (PNI) was significantly lower (P＜0.05). Age, hypertension, previous myocardial infarction, and left main coronary artery disease were identified as risk factors for new-onset heart failure, while PNI was a protective factor (P＜0.05). A nomogram prediction model was successfully developed which demonstrated good predictive performance, with high consistency between predicted and observed values. The model showed favorable net benefit in clinical application. ConclusionThis prediction model can be used for initial assessment of new-onset heart failure risk in elderly AMI patients after PCI, facilitating early identification of high-risk patients and development of personalized treatment plans. |
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