The influencing factors of major adverse cardiovascular events in patients with coronary heart disease after percutaneous coronary intervention and the construction of a column chart model

GUI Yuan; JIANG Yi; ZHAN Ji-dong; HUANG Qin; ZHANG Yi; ZHANG Jing

doi:10.3969/j.issn.1672-5301.2025.01.005

Abstract：Objective To investigate the influencing factors of major adverse cardiovascular events(MACE)in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI),and to establish an effective column chart model for predicting MACE in CHD patients after PCI and validate it.Methods From January 2022 to August 2024,totally 346 confirmed CHD patients admitted to our hospital were regarded as subjects.They were stochastically assigned into the modeling group of 242 cases and the validation group of 104 cases according to a 7∶3 ratio.The patients were assigned into the occurrence group(85 cases)and the non occurrence group(157 cases)based on whether they had MACE.Logistic regression analysis was applied to screen the influencing factors of MACE in the patients.The R software and rms package were applied to construct the column chart risk prediction model for MACE in the patients.ROC curves and calibration graphs were applied to verify the discriminability and consistency of the model.Results Compared with the non occurrence group,the B-type natriuretie peptide(BNP),QT-interval dispersion(QTd),proportions of severe coronary artery calcification,and the numbers of stents≥2 in the occurrence group were obviously higher[(522.19±55.37)ng/L vs.(449.06±50.24)ng/L、(85.47±9.68)ms vs.(72.51±8.23)ms、33.82%vs.19.75%、30.59%vs.14.01%,all P<0.05)],while the levels of albumin(ALB),left ventricular ejection fraction(LVEF)and left anterior descending artery(LAD)were obviously lower[(32.54±4.49)g/L vs.(41.59±5.61)g/L、(33.08±4.65)%vs.(40.25±5.18)%、(42.18±5.24)mm vs.(49.37±5.36)mm,all P<0.05].BNP(OR=1.023),ALB(OR=0.708),QTd(OR=1.290),LVEF(OR=0.773),LAD(OR=0.739)and moderate to severe coronary artery calcification(OR=19.708)were all the influencing factors for MACE in CHD patients(P<0.05).The area under the curve(AUC)for predicting MACE risk using a column chart prediction model was 0.955(95%CI 0.933-0.977),indicating good discrimination,the calibration curve tended towards the ideal curve,and the actual value was in good agreement with the predicted value;in the validation group,the AUC predicted by the column chart for the risk of MACE occurrence was 0.901(95%CI 0.846-0.957).Conclusion BNP,ALB,QTd,LVEF,LAD and the moderate to severe calcification of coronary arteries are all the contributing factors to the occurrence of MACE in CHD patients after PCI.The column chart prediction model has been further successfully constructed,and after verification and analysis,the column chart prediction model can effectively predict the risk of MACE in CHD patients after PCI.