To establish and evaluate a long-term prognosis prediction model for patients with severe coronary artery calcification after rotational atherectomy
WANG Ren-hui
YU Zi-xiang
CHENG Qi
Nazira YALIQIN
LI Xiao-mei
MA Yi-tong
Abstract：Objective To investigate the efficacy of Rotational Atherectomy in patients with severe coronary artery calcification(CAC)lesions.The risk factors of long-term major adverse cardiovascular and cerebrovascular events(MACCE)in patients with severe CAC lesions after RA were analyzed,and the prediction model of long-term MACCE in patients with severe CAC lesions after RA was constructed.Methods A total of 245 patients with severe CAC lesions who underwent RA in the First Affiliated Hospital of Xinjiang Medical University from July 2012 to August 2022 were retrospectively analyzed.The median follow-up time was 49(28.0,70.5)months.The patients were divided into the MACCE group(61 cases)and the non-MACCE group(184 cases)according to whether MACCE occurred during the follow-up period.Lasso regression and multivariate Cox regression analysis were used to determine the independent risk factors for long-term MACCE after RA in patients with severe CAC lesions,and the prediction model was constructed and evaluated on this basis.Result The results of Cox regression analysis showed that the incidence of in-hospital MACCE,glycosylated hemoglobin and N-terminal B-type brain natriuretic peptide(NT-proBNP)is an independent risk factor for long-term MACCE in patients with severe CAC lesions after RA.The C-index of Nomogram model was 0.697,and the Receiver Operating Characteristic curve of 3,4 and 5 years after operation was calculated.The area under the receiver operating characteristic(ROC)was 0.698,0.730 and 0.703,respectively,indicating that the prediction accuracy of the model was good.The calibration chart results showed that the predicted risk of the model was in good agreement with the actual risk.Decision Curve Analysis(DCA)showed that the nomogram model had good clinical applicability.Conclusions The predictive model established in this study can effectively evaluate the risk of long-term MACCE in patients with severe CAC lesions after RA,which can help clinicians to screen high-risk patients and formulate individualized treatment to improve the prognosis of patients.
Keywords：Rotational atherectomyCoronary artery calcificationMajor adverse cardiovascular and cerebrovascular eventsPrediction model
Publication Date：2024-05-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 433-440 )