Correlation between HRV,BRI,and Major Adverse Cardiovascular Events in Patients with Acute Myocardial Infarction after PCI and Construction of a Nomogram Prediction Model

WANG Chunxia; ZHOU Zhu; WANG Shengen

doi:10.3969/j.issn.1002-3429.2025.14.007

Abstract：Objective To analyze the correlation of major adverse cardiovascular events(MACE)with heart rate variability(HRV)parameters,and body roundness index(BRI)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI),to screen for early warning factors for MACE occurrence in patients and to construct a nomogram prognostic prediction model based on these factors.Methods A total of 360 patients with AMI who underwent PCI from January to May 2022 were selected as the research subjects and followed up for 24 months.They were divided into the MACE group and the non-MACE group based on the occurrence of MACE.The clinical data,BRI,and HRV parameters were compared between the two groups.Spearman correlation analysis was used to investigate the relationship between HRV parameters and the occurrence of MACE in patients.Multivariate logistic regression analysis was employed to identify early warning factors for patient prognosis.Based on these early warning factors,a Nomogram prediction model was developed and subjected to internal and external validation.Results During a 24-month follow-up,17 patients were lost to follow-up,and 343 cases were successfully followed up.Among them,119 patients(34.69%)experienced MACE.In the MACE group,the proportion of anterior descending branch as the infarction-related artery,total protein,global registry of acute coronary events(GRACE)score,BRI,and low frequency components(LF)/high frequency components(HF)ratio were higher than those in the non-MACE group,whereas left ventricular ejection fraction(LVEF),hemoglobin,standard deviation of average normal-to-normal(NN)intervals(sDANN),root mean square of the successive differences(RMSSD)of NN intervals,standard deviation of NN intervals(sDNN),and TF were lower in the MACE group than in the non-MACE group(P<0.01).Spearman correlation analysis showed that BRI and LF/HF were positively correlated with the occurrence of MACE in AMI patients(r=0.752,0.817,P<0.01),while sDANN,RMSSD,sDNN,and TF were negatively correlated with the occurrence of MACE in AMI patients(r=-0.736,-0.812,-0.838,-0.796,P<0.01).Multivariate logistic regression analysis revealed that LVEF,hemoglobin,sDANN,RMSSD,sDNN,and TF were protective factors for the prognosis of AMI patients,while anterior descending branch as the infarction-related artery,total protein,GRACE score,LF/HF ratio,and BRI were risk factors(P<0.05,P<0.01).The predictive risk consistency index of the Nomogram prediction model for the prognosis of AMI patients after PCI based on the above factors was 0.914;the calibration curve and decision curve indicated that the model had good consistency in predicting the occurrence of MACE with actual outcomes,and had good clinical net benefit within a threshold probability range of 0.06 to 0.40.Conclusion AMI Patients undergoing PCI have a higher incidence of MACE.The risk factors include the presence of the left anterior descending artery as the infarction-related artery,total protein,GRACE score,and LF/HF ratio,while the protective factors are LVEF,hemoglobin,sDANN,RMSSD,sDNN,and TF.Based on these factors,a Nomogram prognostic prediction model has been constructed,which demonstrates good predictive performance.