Development of a predictive model for the risk of major adverse cardiovascular events in elderly STEMI patients receiving PCI within 3 years

摘要

Objective:To construct and validate a predictive model for predicting the risk of major adverse cardiovascular events(maces)in elderly patients with ST-segment elevation myocardial infarction(STEMI)undergoing PCI within 3 years.Methods:This study is a retrospective cohort study.1745 subjects were randomly divided into modeling cohort and verification cohort according to a ratio of 3:1.LASSO regression model and multivariate Cox regression were used to analyze independent risk factors of major adverse cardiovascular events in elderly STEMI patients who received PCI treatment within 3 years.R software(version 3.5.3)was used to construct a nomogram model to predict the risk of major adverse cardiovascular events in elderly STEMI patients receiving PCI treatment within 3 years,and to compare and verify the model.Results:The results of LASSO regression model and multivariate Cox regression analysis showed that age,history of diabetes,history of atrial fibrillation,cardiac function classification,coronary angiography results,and GRACE risk score were the major adverse cardiovascular diseases in elderly STEMI patients who received PCI treatment within 3 years.Independent risk factors for event risk.The prediction model was verified internally and externally.The AUC value in the modeling cohort was 0.890(95%CI:0.856-0.924);the AUC value in the verification cohort was 0.861(95%CI:0.830-0.957).The Hosmer-Lemeshow test results indicate that the prediction model has good stability.Conclusion:The simple and easy-to-use nomogram model in this study can effectively predict the individualized risk of major adverse cardiovascular events in elderly STEMI patients undergoing PCI treatment within 3 years.