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Construction of a risk prediction model for 1-year readmission in patients undergoing percutaneous coronary intervention treated with bayaspirin combined with clopidogrel

Published on Oct. 14, 2024Total Views: 222 times Total Downloads: 46 times Download Mobile

Author: LYU Yuan 1 CHEN Peipei 2 WU Qiongbi 1 ZHANG Wei 1

Affiliation: 1. Department of Cardiology, Lishui People's Hospital, Lishui 323000, Zhejiang Province, China 2. Department of Emergency, Lishui People's Hospital, Lishui 323000, Zhejiang Province, China

Keywords: Myocardial infarction Percutaneous coronary intervention Readmission Predictive model Bayaspirin Clopidogrel

DOI: 10.12173/j.issn.2097-4922.202407036

Reference: LYU Yuan, CHEN Peipei, WU Qiongbi, ZHANG Wei.Construction of a risk prediction model for 1-year readmission in patients undergoing percutaneous coronary intervention treated with bayaspirin combined with clopidogrel[J].Yaoxue QianYan Zazhi,2024, 28(1):41-48.DOI: 10.12173/j.issn.2097-4922.202407036.[Article in Chinese]

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Abstract

Objective  To explore the risk factors of 1-year readmission in patients after percutaneous coronary intervention (PCI) treated with Bayaspirin combined with Clopidogrel and to construct a risk prediction model.

Methods  The clinical data of patients with myocardial infarction (MI) who underwent primary PCI in the Department of Cardiovascular Medicine of Lishui People's Hospital from January 2020 to June 2023 were retrospectively analyzed. The patients were divided into the readmission group (RG) and the non-readmission group (NRG) according to whether they were readmitted due to myocardial reinfarction or complications of MI within 1 year. Univariate analysis was used to explore the differential variables between the RG and NRG groups. Multivariate Logistic regression (Stepwise) was used to explore the risk factors of 1-year readmission in patients after PCI and the "optimal model". The "optimal model" was visualized using R software and transformed into a nomogram risk prediction model. The predictive ability of the Nomogram risk prediction model was evaluated using the receiver operating characteristic (ROC) curve. The calibration of the Nomogram risk prediction model was evaluated using the calibration curve (resampling, Bootstrap n=1 000). The net benefit of the nomogram risk prediction model was evaluated using the decision curve.

Results  A total of 100 patients were included in the study and the readmission rate within 1 year was 34.00%. Age (≥63 years old), diabetes, the number of diseased vessels (≥2), monocyte-high-density lipoprotein ratio (≥0.36), and prognosis nutrition (<39.39) were independent risk factors for readmission in patients with MI after PCI (all P<0.05). ROC analysis showed that the readmission risk prediction model had a good predictive efficiency for readmission in patients with MI after PCI, with an area under ROC curve of 0.903 (95% CI: 0.836-0.970). The calibration curve showed that the "predicted readmission probability" was approximately consistent with the "actual readmission probability"; the decision curve showed that the net benefit of the readmission risk prediction model nomogram was higher than that of the "all" clinical net benefit.

Conclusion  The readmission prediction model of patients with MI after PCI constructed in this study can accurately identify high-risk groups of readmission and may be beneficial for the standardized management of patients after PCI in clinical practice, improve the long-term prognosis of patients.

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References

1.许佳预, 张博方, 陈静. 光学相干断层成像技术指导经皮冠状动脉介入治疗在冠状动脉分叉病变的应用[J]. 中国循证心血管医学杂志, 2024, 16(2): 234-236, 240. [Xu JY, Zhang BF, Chen J. Application of optical coherence tomography-guided percutaneous coronary intervention in coronary bifurcation lesions[J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2024, 16(2): 234-236, 240.] DOI: 10.3969/j.issn.1674-4055.2024.02.28.

2.王雨桐, 闫伟, 徐怡楠, 等. 经皮冠状动脉介入治疗术后发生主要不良心血管事件的危险因素分析和Nomogram模型的构建[J]. 中国循证心血管医学杂志, 2023, 15(9): 1101-1104, 1109. [Wang YT, Yan W, Xu YA, et al. Risk factors of major adverse cardiovascular events and establishment of Nomogram model after percutaneous coronary intervention[J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2023, 15(9): 1101-1104, 1109.] DOI: 10.3969/j.issn.1674-4055.2023.09.18.

3.郝云涛, 丁玲玲, 万艳波, 等. 急性STEMI患者pPCI术后6个月内MACE的影响因素分析及风险预测Nomogram模型构建[J]. 数理医药学杂志, 2024, 37(2): 108-118. [Hao YT, Ding LL, Wan YB, et al. Analysis of the influencing factors of MACE within 6 months after pPCI in acute STEMI patients and construction of risk prediction Nomogram model[J]. Journal of Mathematical Medicine, 2024, 37(2): 108-118.] DOI: 10.12173/j.issn. 1004-4337.202310106.

4.Desai NR, Ross JS, Kwon JY, et al. Association between hospital penalty status under the hospital readmission reduction program and readmission rates for target and nontarget conditions[J]. JAMA, 2016, 316(24): 2647-2656. DOI: 10.1001/jama.2016.18533.

5.中华医学会心血管病学分会, 中华心血管病杂志编辑委员会, 《中国循环杂志》编辑委员会.急性心肌梗死诊断和治疗指南[J]. 中华心血管病杂志, 2001, 29(12): 710-725. DOI: 10.3760/j:issn:0253-3758.2001. 12.003.

6.张萌, 许艳, 郑红艳. 急性心肌梗死患者经皮冠状动脉介入术后1年内再入院风险预测列线图模型构建与评估[J]. 实用心脑肺血管病杂志, 2022, 30(3): 17-21. [Zhang M, Xu Y, Zheng HY. Construction and evaluation of nomogram model for predicting the risk of readmission within 1 year after percutaneous coronary intervention in patients with acute myocardial infarction[J]. Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 2022, 30(3): 17-21.] DOI: 10.12114/j.issn.1008- 5971.2022.00.058.

7.刘延旭, 罗豪, 文聪, 等. NSTEMI患者PCI术后再入院风险预测模型的建立及验证[J]. 川北医学院学报, 2024, 39(5): 598-602. [Liu YX, Luo H, Wen  C, et  al. Establishment and validation of a readmission risk prediction model for patients with non-ST elevation myocardial infarction after primary percutaneous coronary intervention[J]. Journal of North Sichuan Medical College, 2024, 39(5): 598-602.] DOI: 10.3969/j.issn.1005-3697. 2024.05.005.

8.樊秀红. 急性冠状动脉综合征患者经介入治疗术后再入院的影响因素调查[J]. 现代医学与健康研究电子杂志, 2024, 8(1): 16-18. [Fan XH. Investigation on influencing factors of readmission after interventional therapy in patients with acute coronary syndrome[J]. Modern Medicine and Health Research, 2024, 8(1): 16-18.] DOI: 10.3969/j.issn.2096-3718.2024.01.006.

9.徐文君. PCI术后30天非计划再入院风险预测模型构建研究[D]. 南昌: 南昌大学, 2022. DOI: 10.27232/d.cnki.gnchu.2022.001196.

10.张燕妮. 心力衰竭患者出院后再入院的影响因素研究[J]. 实用心脑肺血管病杂志, 2017, 25(2): 13-16. [Zhang YN. Influencing factors of rehospitalization in post-discharge patients with heart failure[J]. Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 2017, 25(2): 13-16.] DOI: 10.3969/j.issn.1008-5971.2017. 02.004.

11.丁胜楷, 黄海涛, 章美华, 等. 急性心肌梗死患者行PCI后1年的生存状况及相关因素分析[J]. 心脑血管病防治, 2019, 19(4): 315-317. [Ding SK, Huang HT, Zhang MH, et al. Survival status and related factors of patients with acute myocardial infarction one year after percutaneous coronary in-tervention[J]. Prevention and Treatment of Cardio-Cerebral-Vascular Disease, 2019, 19(4): 315-317.] DOI: 10.3969/j.issn.1009_816x. 2019.04.008.

12.尉驰, 袁平年, 郭文怡. 急性冠状动脉综合征患者经皮冠状动脉介入治疗术后6个月内再入院危险因素分析[J]. 中国心血管杂志, 2019, 24(3): 218-222. [Wei C, Yuan PN, Guo WY. Risk factors for readmission in patients with acute coronary syndrome within 6 months after percutaneous coronary intervention[J]. Chinese Journal of Cardiovascular Medicine, 2019, 24(3): 218-222.] DOI: 10.3969/j.issn.1007-5410.2019.03.004.

13.刘鸣, 张峰, 葛雷, 等. 冠状动脉多支血管病变和慢性完全闭塞性病变对急性ST段抬高型心肌梗死患者住院期间预后的影响[J]. 上海医学, 2015, 38(3): 199-204. [Liu M, Zhang F, Ge L, et al. Impact of multivessel disease and chronic total occlusion on in-hospital outcome in acute ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention[J]. Shanghai Medical Journal, 2015, 38(3): 199-204.] DOI: CNKI:SUN:SHYX.0.2015-03-008.

14.张政, 陈雪儿, 卢献灵. 慢性阻塞性肺疾病患者外周血中冷诱导RNA结合蛋白和髓样细胞触发受体-1的表达水平及其临床意义[J]. 安徽医科大学学报, 2024, 59(7): 1275-1280. [Zhang Z, Chen XE, Lu XL. The expression levels and clinical significance of cold induced RNA binding protein and myeloid cell trigger receptor-1 in peripheral blood of patients with chronic obstructive pulmonary disease[J]. Acta Universitatis Medicinalis Anhui, 2024, 59(7): 1275-1280.] DOI: 10.19405/j.cnki.issn1000-1492.2024.07.026.

15.徐正文, 严喜胜, 李东升. MHR与高血压合并冠心病患者发生多支血管病变的相关性[J]. 检验医学与临床, 2024, 21(9): 1191-1197. [Xu ZW, Yan XS, Li DS. Correlation between MHR and multivessel disease in patients with hypertension complicated with coronary heart disease[J]. Laboratory Medicine and Clinic, 2024, 21(9): 1191-1197.] DOI: 10.3969/j.issn.1672-9455.2024. 09.002.

16.张尊祺, 章福彬, 史靖. 单核细胞计数/高密度脂蛋白胆固醇比值与急性胰腺炎的相关性研究[J]. 肝胆外科杂志, 2023, 31(6): 440-443. [Zhang ZQ, Zhang FB, Shi J. The correlation between monocyte count/high-density lipoprotein cholesterol ratio and acute pancreatitis[J]. Journal of Hepatobiliary Surgery, 2023, 31(6): 440-443.] DOI: 10.3969/j.issn.1006-4761.2023.06.012.

17.李晴, 李冬, 宋肖倩, 等. NHR和MHR联合检测与STEMI患者院内心衰的相关性[J]. 西部医学, 2023, 35(7): 1063-1067. [Li Q, Li D, Song XQ, et al. NHR and MHR combined test studies associated with hospital heart failure in patients with STEMI[J]. Medical Journal of West China , 2023, 35(7): 1063-1067.] DOI: 10.3969/j.issn.1672-3511.2023.07.024.

18.樊欢欢, 丁成. 老年食管癌术后患者胃肠功能指标及炎症指标与患者预后的相关性[J]. 中国老年学杂志, 2024, 44(11): 2604-2607. [Fan HH, Ding C. Correlation between gastrointestinal function indexes, inflammatory indexes and prognosis of elderly patients after esophageal cancer surgery[J]. Chinese Journal of Gerontology, 2024, 44(11): 2604-2607.] DOI: 10.3969/j.issn.1005-9202.2024.11.012.

19.刘琳, 王天凯, 秦康春凤, 等. MLR与冠心病和冠状动脉病变程度相关性分析[J]. 检验医学, 2024, 39(5): 485-490. [Liu L, Wang TK, Qin KCF, et al. Correlations between monocyte-to-lymphocyte ratio with coronary heart disease and the extent of coronary atherosclerosis[J]. Laboratory Medicine, 2024, 39(5): 485-490.] DOI: 10.3969/j.issn.1673-8640.2024.05.013.

20.路曼, 周小春, 刘芳香, 等. 糖尿病肾病合并心血管疾病的影响因素分析及风险预测模型构建[J]. 中国医药, 2023, 18(12): 1812-1816. [Lu M, Zhou XC, Liu FX, et al. Influencing factors analysis and risk prediction model construction of diabetic nephropathy with cardiovascular disease[J]. China Medicine, 2023, 18(12): 1812-1816.] DOI: 10.3760/j.issn.1673-4777.2023.12.012.

21.马新. 淋巴细胞与单核细胞比值、预后营养指数对静脉溶栓治疗的急性缺血性脑卒中患者短期预后的预测价值[J]. 国际检验医学杂志, 2022, 43(16): 1984-1988, 1993. [Ma X. Predictive value of lymphocyte to monocyte ratio and prognostic nutrition index for short-term prognosis of acute ischemic stroke patients treated with intravenous thrombolysis[J]. International Journal of Laboratory Medicine, 2022, 43(16): 1984-1988, 1993.] DOI: 10.3969/j.issn.1673-4103.2022.16.014.

22.迪力夏提·吾布力, 田桃, 张兴达, 等. 急性ST段抬高型心肌梗死患者发生心脏破裂的风险预测模型构建及验证[J]. 中国老年学杂志, 2020, 40(3): 449-453. [Dilixiati WBL, Tian T, Zhang XD, et al. Construction and verification of risk prediction model for cardiac rupture in patients with acute ST-segment elevation myocardial infarction[J]. Chinese Journal of Gerontology, 2020, 40(3): 449-453.] DOI: 10.3969/j.issn.1005-9202.2020.03.001.

23.王欲清, 李紫梦, 马宏文. 急性心肌梗死患者非计划性再入院危险因素分析及风险预测模型构建[J]. 中国实用护理杂志, 2022, 38(11): 817-822. [Wang YQ, Li ZM, Ma HW. Risk factors analysis and construction of risk prediction model for unplanned readmission in patients with acute myocardial infarction[J]. Chinese Journal of Practical Nursing, 2022, 38(11): 817-822.] DOI: 10.3760/cma.j.cn211501-20210907-02547.

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