Development and validation of a clinical predictive model for 1-year prognosis in coronary heart disease patients combine with acute heart failure

Abstract

BackgroundThe risk factors for acute heart failure (AHF) vary, reducing the accuracy and convenience of AHF prediction. The most common causes of AHF are coronary heart disease (CHD). A short-term clinical predictive model is needed to predict the outcome of AHF, which can help guide early therapeutic intervention. This study aimed to develop a clinical predictive model for 1-year prognosis in CHD patients combined with AHF.Materials and methodsA retrospective analysis was performed on data of 692 patients CHD combined with AHF admitted between January 2020 and December 2020 at a single center. After systemic treatment, patients were discharged and followed up for 1-year for major adverse cardiovascular events (MACE). The clinical characteristics of all patients were collected. Patients were randomly divided into the training (n = 484) and validation cohort (n = 208). Step-wise regression using the Akaike information criterion was performed to select predictors associated with 1-year MACE prognosis. A clinical predictive model was constructed based on the selected predictors. The predictive performance and discriminative ability of the predictive model were determined using the area under the curve, calibration curve, and clinical usefulness.ResultsOn step-wise regression analysis of the training cohort, predictors for MACE of CHD patients combined with AHF were diabetes, NYHA ≥ 3, HF history, Hcy, Lp-PLA2, and NT-proBNP, which were incorporated into the predictive model. The AUC of the predictive model was 0.847 [95% confidence interval (CI): 0.811–0.882] in the training cohort and 0.839 (95% CI: 0.780–0.893) in the validation cohort. The calibration curve indicated good agreement between prediction by nomogram and actual observation. Decision curve analysis showed that the nomogram was clinically useful.ConclusionThe proposed clinical prediction model we have established is effective, which can accurately predict the occurrence of early MACE in CHD patients combined with AHF.

Construction of a web‐based dynamic nomogram for predicting the prognosis in acute heart failure

“…Some studies reported that demographic information (age), clinical manifestations (NYHA functional class, SBP, DBP, and MAP), pre‐existing conditions (diabetes mellitus and AF), medications (vasopressors), laboratory tests (NT‐proBNP, haemoglobin, sodium, albumin, creatinine, blood urea nitrogen, and eGFR), and 12‐lead resting ECG (RBBB) were significantly associated with OS 8,9,37–40 . However, in the other studies, there was no apparent association of demographic information (age), clinical manifestations (SBP and DBP), pre‐existing conditions (AF), medications, and laboratory tests (NT‐proBNP, haemoglobin, sodium, and creatinine) with long‐term survival 41–43 . To our knowledge, this study is the first risk stratification model to consider including VHD, CRT, and indicators of SPECT MPI (i.e.…”

“…8,9,37-40 However, in the other studies, there was no apparent association of demographic information (age), clinical manifestations (SBP and DBP), pre-existing conditions (AF), medications, and laboratory tests (NT-proBNP, haemoglobin, sodium, and creatinine) with long-term survival. [41][42][43] To our knowledge, this study is the first risk stratification model to consider including VHD, CRT, and indicators of SPECT MPI (i.e. rest scar burden) to predict the prognosis of AHF.…”

The relationships between biological novel biomarkers Lp‐PLA2 and CTRP‐3 and CVD in patients with type 2 diabetes mellitus

“…Furthermore, Lp‐PLA 2 levels may reflect the degree of atherosclerotic plaque instability and the severity of coronary artery disease 13 . Huang et al reported a positive correlation between plasma Lp‐PLA 2 concentrations and major adverse cardiovascular events in patients experiencing acute myocardial infarction, which intimates a potential role for Lp‐PLA 2 in the pathogenesis and progression of myocardial infarction 14 . Nevertheless, the correlation between Lp‐PLA 2 and CVD in T2DM warrants further rigorous investigation.…”