Risk Factors and Risk Dynamic Nomogram Model for MACE after Stent Implantation for Borderline Coronary Artery Lesions

PAN Qiangqiang; LU Jiazhong

doi:10.12102/j.issn.1672-1349.2026.01.018

Abstract：Objective: To explore the risk factors for major adverse cardiovascular events (MACE) after stent implantation in patients with coronary artery lesions, and to construct a nomogram model for predicting MACE after stent implantation in patients with coronary artery lesions. Methods: A total of 320 patients with coronary artery lesions who underwent stent implantation between January 2022 and June 2023 were selected as the study subjects. LASSO analysis was used to screen predictive factors for MACE after stent implantation in patients with coronary artery lesions. Logistic regression was used to identify risk factors for MACE after stent implantation in patients with coronary artery lesions. The nomogram model for predicting MACE after stent implantation in patients with coronary artery lesions was constructed using R software, and internal validation of the nomogram model was performed. Results: Among the 320 patients with coronary artery lesions, 62 experienced MACE after surgery, with an incidence rate of 19.38% (62/320). Logistic regression analysis showed that high-sensitivity C-reactive protein (hs-CRP), number of coronary artery lesions ≥3 vessels, smoking, diabetes, hypertension, and red cell distribution width (RDW) were risk factors for MACE after stent implantation in patients with coronary artery lesions (P < 0.05). A dynamic nomogram model was established based on these risk factors. The C-index of the nomogram model for predicting MACE after stent implantation in patients with coronary artery lesions was 0.955 [95% CI (0.932, 0.977)]; the predicted probability and actual probability from the calibration curve were basically consistent; the area under the receiver operating characteristic (ROC) curve was 0.943 [95% CI (0.915, 0.971)]; decision curve analysis showed that when the threshold probability ranged from 1% to 100%, the net benefit of the nomogram in predicting MACE after stent implantation in patients with coronary artery lesions was high. Conclusion: hs-CRP, number of coronary artery lesions ≥3 vessels, smoking, diabetes, hypertension, and RDW are risk factors for MACE after stent implantation in patients with coronary artery lesions. The constructed dynamic nomogram model for predicting MACE after stent implantation in patients with coronary artery lesions has high accuracy and clinical practicality.