Analyze the risk factors of incomplete revascularization in elderly patients with coronary heart disease and multivessel disease and to construct a prediction model

Yu Hui; Wang Yongjun; Li Rong; Fan Qunhua; Luo Caidong

doi:10.3969/j.issn.1671-6450.2025.09.001

Abstract：Objective To investigate the independent risk factors of major adverse cardiovascular events(MACE)af-ter incomplete revascularization in elderly patients with coronary heart disease combined with multi-vessel disease,establish a predictive model based on clinical indicators and verify its efficacy.Methods A total of 143 elderly patients with coronary heart disease and multi-vessel disease were selected from November 2022 to November 2023.The data set was divided into a training set(100 cases)and a verification set(43 cases)using the train_test_split function in the sklearn toolkit.The training set was divided into MACE group(n=28)and non-MACE group(n=72)according to whether MACE was present in the training set.By comparing the baseline data of the two groups,multivariate Logistic regression was used to analyze the ad-verse prognostic factors,and a neagram model and model efficacy were established.Results There was no statistical signifi-cance between the training set and the verification set(P＞0.05).Compared with the non-MACE group,the age,diabetes and abnormal glucose tolerance ratio,Cr and UA levels in the MACE group were higher than those in the non-MACE group(P＜0.05),the male ratio,UB level and TIMI blood flow grade in the MACE group were lower than those in the non-MACE group(P＜0.05),and there were no statistically significant differences among other indicators(P＞0.05).Multivariate Logistic regres-sion analysis showed abnormal glucose tolerance[OR=1.656,95％CI:1.049-1.818],SCr[OR=1.071,95％CI:1.013-1.598],UA[OR=1.079,95％CI:1.012-1.663]and TIMI blood flow grade[OR=1.083,95％CI:1.027-1.196]were risk factors for poor prognosis(P＜0.05).The nomogram model shows that the consistency index of training set and verification set are 0.812 and 0.809,respectively.The AUC was 0.836(95％CI:0.709-0.875)and 0.901(95％CI:0.722-0.983),respectively.Conclusion Abnormal glucose tolerance,increased Cr and UA,and decreased TIMI blood flow grade are independent risk factors for MACE after incomplete re-vasculopathy in elderly patients with multi-vessel coronary heart disease.The constructed histogram model has good predictive efficacy.Clinical attention should be paid to glucose metabolism,renal func-tion and hemodynamic management to improve prognosis.