Risk factors and nomogram prediction model construction for postoperative arrhythmia in patients with coronary heart disease after percutaneous coronary intervention

Gao Zhenhua; Zhou Shuzhen; Meng Yintai

doi:10.3969/j.issn.1674-4055.2025.07.19

Abstract：Objective To analyze the risk factors for postoperative arrhythmia occurrence and construct a nomogram prediction model in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods A total of 51 patients with CHD were selected in Department of Cardiovascular Medicine at the Third Affiliated Hospital of Henan University of Science and Technology from Aug.2020 to Aug.2023.The influencing factors of arrhythmia occurrence after PCI were screened by using singe-factor and multi-factor Logistic regression analyses in CHD patients.A nomogram model was constructed based on significant predictors from multivariate analysis.The discrimination and calibration of the nomogram model were evaluated by using receiver operating characteristic(ROC)curve and calibration curve,while the net benefit of the model was analyzed by using decision curve analysis(DCA).Results Multi-coronary lesions(OR=8.255,95％CI:1.707～39.912,P=0.009),diabetes(OR=10.577,95％CI:1.944～57.538,P=0.006)and growth differentiation factor-15(GDF～15,OR=1.119,95％CI:1.069～1.171,P=0.000)were risk factors for arrhythmia occurrence in CHD patients after PCI(P＜0.05).Grade Ⅲ TIMI flow grading(OR=0.123,95％CI:0.023～0.668,P=0.015),Apelin(OR=0.841,95％CI:0.784～0.902,P=0.000)and post-PCI reflow(OR=0.041,95％CI:0.004～0.456,P=0.009)were independent predictive factors for arrhythmia occurrence in CHD patients after PCI(P＜0.05).The AUC of ROC curve and the AUC of 500 bootstrap internal verifications were 0.969 and 0.976,respectively.In addition,the calibration curve proved the consistency between predicted probability and the actual probability,and the decision curve analysis showed a good net benefit interval.Conclusion The arrhythmia occurrence is correlated to coronary lesion vessels,diabetes,GDF-15 and Apelin,and the nomogram model has a higher predictive value to arrhythmia occurrence in CHD patients after PCI.