A nomogram to predict major adverse cardiovascular events of patients with acute chest pain, Non-ST-segment deviation, and normal troponin concentrations
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1Department of Cardiology, Tianjin Fifth Central Hospital, Tianjing, P.R. China. duxinpingdr@163.com.
Insights
This study identifies key predictors for major adverse cardiovascular events (MACE) in low-risk chest pain patients. A developed nomogram aids in predicting MACE risk and guiding preventive strategies.
Area of Science:
- Cardiology
- Preventive Medicine
- Medical Diagnostics
Background:
- Chest pain is a common symptom with varying underlying causes.
- Accurate risk stratification is crucial for managing patients presenting with low-risk chest pain.
- Identifying early indicators of major adverse cardiovascular events (MACE) can improve patient outcomes.
Purpose of the Study:
- To identify predictors of 1-year MACE in patients with low-risk chest pain.
- To develop a nomogram for predicting MACE in this patient cohort.
- To aid in the early detection and prevention of cardiovascular events.
Main Methods:
- A cohort of patients with low-risk chest pain was followed for 1 year.
- Multivariable Cox regression analysis was used to identify independent predictors of MACE.
- A predictive nomogram was constructed based on significant predictors.
Main Results:
- The incidence of MACE within 1 year was 6.94%.
- Independent predictors for MACE included risk factors of coronary artery disease (CAD), P-terminal force in lead V1 (PTFV1), C-reactive protein (CRP), and the ratio of early diastolic peak velocity to peak early diastolic velocity (E/Em).
- The constructed nomogram demonstrated good discrimination (C-index = 0.79) and calibration.
Conclusions:
- Risk factors of CAD, PTFV1, CRP, and E/Em are significant predictors of 1-year MACE in low-risk chest pain patients.
- The developed nomogram serves as a user-friendly tool for predicting MACE.
- This tool can assist in identifying high-risk patients and informing preventive treatment strategies.
Objective:
To explore the potential indicators including patients' characteristics, electrocardiogram (ECG), echocardiography, and serological assay in predicting the major adverse cardiovascular events (MACE) within 1 year for patients with low-risk chest pain with a nomogram.
Patients And Methods:
The detected indicators of patients with low-risk chest pain were obtained as the alternative predictors for MACE. After the 1-year follow-up, patients with MACE were enrolled in the MACE group while the remained patients were in the non-MACE group. A nomogram was constructed based on the multivariable Cox regression to link the independent predictors and the MACE within 1 year for patients with low-risk chest pain.
Results:
The incidence of MACE within 1 year was 6.94% according to the follow-up result. Multivariate analysis revealed that risk factors of CAD, P-terminal force in lead V1 (PTFV1), C-reactive protein (CRP), and transmitral inflow early diastolic peak velocity (E wave) /peak early diastolic velocity (Em) (E/Em) were the independent predictors for the MACE. A nomogram incorporating these independent predictors with a good discrimination (0.79 in C-index) and calibration was constructed to predict the incidence of MACE within 1 year. It could be used to help select the patients with a high risk of MACE and develop preventive treatment strategies.
Conclusions:
Risk factors of CAD, PTFV1, CRP, and E/Em were the independent predictors for the MACE within 1 year in patients with low-risk chest pain. The present nomogram provides a user friendly tool in the prediction of MACE for these patients.
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