Risk Factors of Long-term MACCE in Premature Coronary Heart Disease and Prediction Model Construction

DENG Binghui; WANG Jian; FEI Liang; WANG Yijing; CHEN Liangyu

doi:10.12102/j.issn.1672-1349.2025.12.017

Abstract：Objective: To explore the risk factors for long-term major adverse cardiac and cerebral events (MACCE) in early-onset coronary heart disease (CHD), and to construct a predictive model, aiming to provide more references for the early identification of high-risk populations for MACCE and the formulation of clinical prevention and treatment strategies. Methods: A retrospective cohort study was conducted on 391 patients with early-onset CHD who were treated at our hospital between January 2017 and January 2023. Patients were divided into non-MACCE group and MACCE group according to whether MACCE occurred during 24-month follow-up. Univariate and multivariate analyses were used to evaluate independent risk factors for long-term MACCE in early-onset CHD. A predictive model for the risk of long-term MACCE in early-onset CHD was constructed and its performance analyzed. Results: Among the 391 patients, 31 cases experienced MACCE during 24-month follow-up, with an incidence rate of 7.93%. The MACCE group had significantly higher numbers of coronary artery lesions, preoperative SYNTAX scores, low-density lipoprotein cholesterol (LDL-C), and LDL-C/high-density lipoprotein cholesterol (HDL-C) levels compared to the non-MACCE group (P < 0.05). Multivariate analysis showed that preoperative high SYNTAX score, multi-vessel coronary artery disease, and high LDL-C/HDL-C ratio were independent risk factors for long-term MACCE in early-onset CHD (P < 0.05). Using LDL-C/HDL-C ratio, number of coronary artery lesions, preoperative SYNTAX score, and logistic regression model P values to predict the risk of long-term MACCE in early-onset CHD, the Youden indices were 0.80, 0.58, 0.49, and 0.94, respectively. Conclusion: The occurrence of long-term MACCE in early-onset CHD is related to preoperative SYNTAX score, number of coronary artery lesions, and LDL-C/HDL-C ratio. The predictive model constructed based on these indicators can accurately predict the risk of long-term MACCE.