Construction of Nomogram Model for the Risk of MACE in Patients with Chronic Total Occlusion of Coronary Arteries after PCI
CHEN Minna
XING Xue
ZHANG Wang
LYU Weikun
DONG Huanle
WANG Wenli
KANG Qi
NIU Tie
DONG Jing
Abstract：Objective:To construct the nomogram model for predicting the risk of recent major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in patients with chronic total occlusion(CTO)of the coronary arteries,and to evaluate the predictive accuracy.Methods:The CTO of coronary arteries patients who underwent PCI interventional treatment were selected,and followed up for 1 year.Based on the results of the 1-year follow-up,the patients were divided into the MACE occurrence group and the MACE non-occurrence group.There were the patients(70%)from the overall study were randomly selected as the training set and 30%patients as the test set Logistic regression was used to analyze the independent risk factors for MACE in the training set,and nomogram model was constructed based on the independent risk factors obtained from the analysis.The constructed column chart model was validated in 3 aspects:evaluating the predictive efficacy of the column chart model by receiver operating characteristic(ROC)curve,plotting calibration curves to evaluate and validate the consistency of the risk prediction model,and validating the model's benefit by the clinical decision curve.Results:A total of 280 patients were included,including 96 patients with MACE.Among the 196 patients in the training set,and 67 patients with MACE,there were 84 patients in the test set,29 patients with MACE.Independent risk factors for MACE in the training set analyzed by Logistic regression were PCI intervention failure,older age,smoking,diabetes mellitus,lower left ventricular ejection fraction(LVEF),and higher low-density lipoprotein cholesterol(LDL-C).ROC curve verification of the constructed nomogram model showed that both the training set and the test set showed better prediction efficiency,and the area under ROC curve(AUC)of the training set was 0.854,and that of the AUC of the test set was 0.832.The calibration curves showed better predictive performance for both the training and test sets,with concordance index(C-index)of 0.879 for the training set and concordance index(C-index)of 0.856 for the test set.The optimal range of clinical decision curve in the training set was 0.04-0.95,that in the test set was 0.06-0.91,suggesting that both of them showed great clinical benefit.Conclusion:PCI intervention failure,older age,smoking,diabetes mellitus,low LVEF and high LDL-C were independent risk factors for MACE with CTO of coronary arteries patients.The nomogram model constructed on the basis of the above independent risk factors had good predictive accuracy and clinical applicability
Keywords：coronary heart diseasechronic total occlusion of coronary arteriespercutaneous coronary interventionmajor adverse cardiovascular eventsnomogram modelprognosis
Publication Date：2023-12-16
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 4490-4496 )