Risk factors and prediction model construction for myocardial injury after non-cardiac surgery in diabetic patients
DING Ruida
LYU Meng
WANG Dong
WANG Yuelan
Abstract：Objective To investigate risk factors for postoperative myocardial injury in diabetic patients and construct a predictive model for myocardial injury after non-cardiac surgery(MINS)in diabetic patients through the integration of coronary computed tomography angiography(CCTA)anatomical features and perioperative clinical indicators.Methods A retrospective analysis was conducted on 242 diabetic patients who underwent non-cardiac surgery and preoperative CCTA within six months at Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 1st to September 30th,2023.Patients were classified into MINS group(n=54)and non-MINS group(n=188),according to whether MINS occurs.LASSO regression and multivariable logistic regression were used to identify risk factors for postoperative myocardial injury in diabetic patients,followed by nomogram construction.Results LASSO regression identified left anterior descending lesions,diuretic dosage,number of diseased vessels,coronary stent history,anemia,total cholesterol,and systolic blood pressure as key predictors.Multivariable logistic regression confirmed left anterior descending lesions(OR=2.49,95%CI 1.24-5.04,P=0.011),coronary stent history,diuretic dosage,systolic blood pressure,and anemia as independent risk factors.The nomogram demonstrated good discrimination(AUC=0.778,95%CI 0.709-0.847;sensitivity=0.702,specificity=0.686)and internal validation consistency(mean bootstrapped AUC=0.765,95%CI 0.738-0.782).Hosmer-Lemeshow test indicated adequate calibration(χ2=11.416,P=0.179).Decision curve analysis(DCA)revealed superior net benefit within a threshold probability range from 0.1 to 0.9.Conclusion Left anterior descending lesions are predictive of MINS in diabetic patients.The integrated model combining perioperative factors effectively stratifies MINS risk in diabetic patients.
Keywords：coronary CT angiographymyocardial injury after non-cardiac surgerydiabetes mellitusrisk factorspredictive models
Publication Date：2025-10-15
Online Publishing Date：2025-09-30(First online date of this platform, not the publication date of the document)
Pages：7( 369-375 )