AIM To explore the in-hospital independent risk factors of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) and to construct a risk prediction model.
METHODS Two hundred and seventy-six ACS patients treated in our hospital from June 2019 to June 2021 were selected and divided into MACE group (73 cases) and non-MACE group (203 cases) according to whether the patients had MACE during hospitalization after PCI. The clinicopathological characteristics of the two groups of patients were analyzed by univariate analysis, risk factors of MACE in the hospital after PCI were analyzed by multivariate Logistic regression and the predictive power of the model was valued by ROC curves.
RESULTS The incidence of mace in 276 patients with acute coronary syndrome after percutaneous coronary intervention was 26.45%; The clinical data of two groups of patients were compared. The results showed that patients in group MACE were older than 60 (P<0.05), smoking (P<0.05), drinking history (P<0.05), hypertension (P<0.01), heart function Killip grade 3 (P<0.05) and diabetes (P<0.05) accounted for higher than those in non MACE group. BMI (P<0.05), neutrophil count (P<0.05), WBC (P<0.05), NT Pro BNP (P<0.01), LDL-C (P<0.05), SCR (P<0.01), C-reactive protein (P<0.01), total cholesterol (P<0.05), triglyceride (P<0.01), blood glucose (P<0.05), D-Dimer (P<0.01) and troponin (P<0.01) were significantly higher than those in non mace group; Lymphocyte count (P<0.01), erythrocyte count (P<0.01), hemoglobin concentration (P<0.01), blood sodium (P<0.05), blood calcium (P<0.01), uric acid (P<0.05) and albumin (P<0.01) were significantly lower than those in non mace group. Multivariate logistic regression analysis showed that age (P<0.05), smoking (P<0.05), WBC (P<0.01), NT proBNP (P<0.05) and SCR (P<0.01) were independent risk factors for mace after PCI, and LVEF was protective factor (P<0.05). The total score of six independent influencing factors was 279.14, and the corresponding risk value was 0.82. It was predicted that the probability of mace in the hospital after PCI in patients with ACS was 82%. The ROC curve analysis shows that the area under the ROC curve of the model is 0.846, the 95% confidence interval is 0.781～0.878, and the sensitivity and specificity are 85.36% and 87.74% respectively, indicating that the prediction ability of the model is strong.
CONCLUSION Age, smoking, WBC, NT proBNP and SCR are independent risk factors for mace in the hospital after PCI, and LVEF is the protective factor.
DownLoad: