AIM To investigate the independent risk factors of in-hospital major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction in Xinjiang based on LASSO regression and build a risk prediction model.
METHODS 615 patients with acute ST segment elevation myocardial infarction (STEMI) who were treated at the Heart Center of the First Affiliated Hospital of Xinjiang Medical University from November 2017 to June 2022 were selected. They were divided into the MACE group (n=77) and the non MACE group (n=538) based on whether there were any MACE events in the hospital. Multiple logistic regression analysis was conducted to fit the variables, identify the independent influencing factors of hospital MACE, and construct a column chart prediction model.
RESULTS Compared with the non event group, patients in the hospital MACE group had a higher age (P<0.05), increased white blood cell levels (P<0.01), increased levels of renal function indicators such as creatinine (P<0.01) and urea nitrogen (P<0.01), increased total bilirubin levels (P<0.01), decreased LVEF (P<0.01), and increased number of coronary artery stenosis (P<0.01). The hospitalization treatment status of the two groups of patients was similar, but the proportion of clopidogrel and statins used in the MACE group decreased (both P<0.01); The results of univariate logistic regression analysis showed that age (OR=1.024, 95% CI: 1.004-1.045, P<0.05), LVEF (OR=0.944, 95% CI: 0.915-0.974, P<0.01), Killip IV grade (OR=10.421, 95% CI: 1.218-89.126, P<0.05), total bilirubin (OR=1.131, 95% CI: 1.084-1.180, P<0.01), white blood cells (OR=1.290, 95% CI: 1.194-1.393, P<0.01), urea nitrogen (OR=1.384, 95% CI: 1.232-1.554, P<0.01) Creatinine (OR=1.020, 95% CI: 1.008-1.031, P<0.05) and the number of coronary artery stenosis (OR=1.275, 95% CI: 1.062-1.531, P<0.01) are influencing factors for in-hospital MACE; Multivariate logistic regression analysis showed that LVEF, total bilirubin, white blood cells, and urea nitrogen were independent influencing factors for hospital MACE, and four independent influencing factors were used to construct a column chart model.
CONCLUSION LVEF, total bilirubin, white blood cells, and urea nitrogen are independent influencing factors for hospital MACE.