A prognostic nomogram for long-term major adverse cardiovascular events in patients with acute coronary syndrome after percutaneous coronary intervention

Kong, Shuting; Chen, Changxi; Guo, Zheng; Yao, Hui; Li, Junfeng; Hong, Ying; Wang, Xiaobo; Qiu, Xiang; Zhou, Xiaodong; Lu, Yucheng; Zhou, Hao

doi:10.1186/s12872-021-02051-0

Cited by 6 publications

(14 citation statements)

References 51 publications

(55 reference statements)

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“…Six studies were centered on patients with myocardial infarction (MI) ( 11 , 12 , 21 , 22 , 24 , 35 ). Meanwhile, three studies specifically focused on patients with acute coronary syndrome ( 13 , 23 , 25 ). Notably, Grayson et al ( 31 ) recruited patients undergoing PCI across a spectrum of conditions including stable angina, unstable angina, acute myocardial infarction (AMI), and cardiogenic shock.…”

Section: Resultsmentioning

confidence: 99%

“…The prognostic models were mostly developed within 3 years ( n = 19, 82.6%). Among the 23 studies, 20 were retrospective cohort studies, while two were prospective studies ( 13 , 37 ), and one was a nested case–control study ( 12 ). Approximately 91.3% of the studies ( n = 21) were constructed using Chinese populations, while one study ( 31 ) was based on England individuals, and another study ( 37 ) was based on Spain individuals.…”

Section: Resultsmentioning

confidence: 99%

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Prediction models for major adverse cardiovascular events after percutaneous coronary intervention: a systematic review

Deng,

Wang,

Wan

et al. 2024

Front. Cardiovasc. Med.

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BackgroundThe number of models developed for predicting major adverse cardiovascular events (MACE) in patients undergoing percutaneous coronary intervention (PCI) is increasing, but the performance of these models is unknown. The purpose of this systematic review is to evaluate, describe, and compare existing models and analyze the factors that can predict outcomes.MethodsWe adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 during the execution of this review. Databases including Embase, PubMed, The Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP, and SINOMED were comprehensively searched for identifying studies published from 1977 to 19 May 2023. Model development studies specifically designed for assessing the occurrence of MACE after PCI with or without external validation were included. Bias and transparency were evaluated by the Prediction Model Risk Of Bias Assessment Tool (PROBAST) and Transparent Reporting of a multivariate Individual Prognosis Or Diagnosis (TRIPOD) statement. The key findings were narratively summarized and presented in tables.ResultsA total of 5,234 articles were retrieved, and after thorough screening, 23 studies that met the predefined inclusion criteria were ultimately included. The models were mainly constructed using data from individuals diagnosed with ST-segment elevation myocardial infarction (STEMI). The discrimination of the models, as measured by the area under the curve (AUC) or C-index, varied between 0.638 and 0.96. The commonly used predictor variables include LVEF, age, Killip classification, diabetes, and various others. All models were determined to have a high risk of bias, and their adherence to the TRIPOD items was reported to be over 60%.ConclusionThe existing models show some predictive ability, but all have a high risk of bias due to methodological shortcomings. This suggests that investigators should follow guidelines to develop high-quality models for better clinical service and dissemination.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=400835, Identifier CRD42023400835.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Prediction models for major adverse cardiovascular events after percutaneous coronary intervention: a systematic review

Deng,

Wang,

Wan

et al. 2024

Front. Cardiovasc. Med.

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“…As for patients with acute myocardial infarction (AMI), the PAMI and CADILLAC risk scores were both used to predict 30-day and 1-year mortality in patients after percutaneous coronary intervention (PCI) ( 8 , 11 ). However, these risk scores were limited by the short follow-up and were not accurately reflect the prognoses of patients with CHD, especially in the Chinese population ( 6 , 12 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

“…To our knowledge, several previous studies have selected and analyzed the potential risk factors related to the high incidence of cardiovascular outcomes in patients with CHD (5)(6)(7)(8)(9)(10)(11)(12)(13)(14). GRACE and Thrombolysis in Myocardial Infarction (TIMI) risk scores were recommended to guide clinical practice for patients with ACS in the short or medium term (9,10).…”

Section: Introductionmentioning

confidence: 99%

Daily exercise improves the long-term prognosis of patients with acute coronary syndrome

et al. 2023

Front. Public Health

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ObjectiveTo demonstrate the effect of daily exercise on the incidence of major adverse cardiovascular events (MACE) for patients with acute coronary syndrome (ACS).MethodsA cohort of 9,636 patients with ACS were consecutively enrolled in our retrospective study between November 2015 and September 2017, which were used for model development. 6,745 patients were assigned as the derivation cohort and 2,891 patients were assigned as the validation cohort. The least absolute shrinkage and selection operator (LASSO) regression and COX regression were used to screen out significant variables for the construction of the nomogram. Multivariable COX regression analysis was employed for the development of a model represented by a nomogram. The nomogram was then evaluated for performance traits such as discrimination, calibration, and clinical efficacy.ResultsAmong 9,636 patients with ACS (mean [SD] age, 60.3 [10.4] years; 7,235 men [75.1%]), the 5-year incidence for MACE was 0.19 at a median follow-up of 1,747 (1,160–1,825) days. Derived from the LASSO regression and COX regression, the nomogram has included 15 factors in total including age, previous myocardial infarction (MI), previous percutaneous coronary intervention (PCI), systolic pressure, N-terminal Pro-B-type natriuretic peptide (NT-proBNP), high-density lipoprotein cholesterol (HDL), serum creatinine, left ventricular end-diastolic diameter (LVEDD), Killip class, the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score, left anterior descending (LAD) stenosis (≥50%), circumflex (LCX) stenosis (≥50%), right coronary artery (RCA) stenosis (≥50%), exercise intensity, cumulative time. The 5-year area under the ROC curve (AUC) of derivation and validation cohorts were 0.659 (0.643–0.676) and 0.653 (0.629–0.677), respectively. The calibration plots showed the strong concordance performance of the nomogram model in both two cohorts. Moreover, decision curve analysis (DCA) also showed the usefulness of nomogram in clinical practice.ConclusionThe present work provided a prediction nomogram predicting MACE for patients with ACS after incorporating the already known factors and the daily exercise, which demonstrated the effectiveness of daily exercise on the improvement of prognosis for patients with ACS.

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“…Compared with traditional risk scoring systems, nomogram models integrate more risk factors and obtain numerical probabilities of target events, more accurately quantify risk, and are more flexible to apply. Its application has been reported in predicting the risk of postoperative heart failure in patients with acute myocardial infarction (AMI) ( 4 ), the risk of in-hospital major cardiovascular events in patients with AMI after PCI ( 5 ), and the prognosis of patients with the acute coronary syndrome ( 6 ). In this study, we retrospectively analyzed the clinical characteristics of 466 STEMI patients before emergency PCI, and provided a reference for clinical assessment of the patient’s condition and guiding treatment by constructing a nomogram model to predict the risk of in-hospital MACE in STEMI patients after emergency PCI.…”

Section: Introductionmentioning

confidence: 99%

Construction and evaluation of nomogram model for individualized prediction of risk of major adverse cardiovascular events during hospitalization after percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction

Fang

Chen

Zhang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundEmergency percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) helps to reduce the occurrence of major adverse cardiovascular events (MACEs) such as death, cardiogenic shock, and malignant arrhythmia, but in-hospital MACEs may still occur after emergency PCI, and their mortality is significantly increased once they occur. The aim of this study was to investigate the risk factors associated with MACE during hospitalization after PCI in STEMI patients, construct a nomogram prediction model and evaluate its effectiveness.MethodsA retrospective analysis of 466 STEMI patients admitted to our hospital from January 2018 to June 2022. According to the occurrence of MACE during hospitalization, they were divided into MACE group (n = 127) and non-MACE group (n = 339), and the clinical data of the two groups were compared; least absolute shrinkage and selection operator (LASSO) regression was used to screen out the predictors with non-zero coefficients, and multivariate Logistic regression was used to analyze STEMI Independent risk factors for in-hospital MACE in patients after emergency PCI; a nomogram model for predicting the risk of in-hospital MACE in STEMI patients after PCI was constructed based on predictive factors, and the C-index was used to evaluate the predictive performance of the prediction model; the Bootstrap method was used to repeat sampling 1,000 Internal validation was carried out for the second time, the Hosmer-Lemeshow test was used to evaluate the model fit, and the calibration curve was drawn to evaluate the calibration degree of the model. Receiver operating characteristic (ROC) curves were drawn to evaluate the efficacy of the nomogram model and thrombolysis in myocardial infarction (TIMI) score in predicting in-hospital MACE in STEMI patients after acute PCI.ResultsThe results of LASSO regression showed that systolic blood pressure, diastolic blood pressure, Killip grade II-IV, urea nitrogen and left ventricular ejection fraction (LVEF), IABP, NT-ProBNP were important predictors with non-zero coefficients, and multivariate logistic regression analysis was performed to analyze that Killip grade II-IV, urea nitrogen, LVEF, and NT-ProBNP were independent factors for in-hospital MACE after PCI in STEMI patients; a nomogram model for predicting the risk of in-hospital MACE after PCI in STEMI patients was constructed with the above independent predictors, with a C-index of 0.826 (95% CI: 0.785–0.868) having a good predictive power; the results of H-L goodness of fit test showed χ2 = 1.3328, P = 0.25, the model calibration curve was close to the ideal model, and the internal validation C-index was 0.818; clinical decision analysis also showed that the nomogram model had a good clinical efficacy, especially when the threshold probability was 0.1–0.99, the nomogram model could bring clinical net benefits to patients. The nomogram model predicted a greater AUC (0.826) than the TIMI score (0.696) for in-hospital MACE after PCI in STEMI patients.ConclusionUrea nitrogen, Killip class II-IV, LVEF, and NT-ProBNP are independent factors for in-hospital MACE after PCI in STEMI patients, and nomogram models constructed based on the above factors have high predictive efficacy and feasibility.

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A prognostic nomogram for long-term major adverse cardiovascular events in patients with acute coronary syndrome after percutaneous coronary intervention

Cited by 6 publications

References 51 publications

Prediction models for major adverse cardiovascular events after percutaneous coronary intervention: a systematic review

Prediction models for major adverse cardiovascular events after percutaneous coronary intervention: a systematic review

Daily exercise improves the long-term prognosis of patients with acute coronary syndrome

Construction and evaluation of nomogram model for individualized prediction of risk of major adverse cardiovascular events during hospitalization after percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction

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