PTH Predicts the in-Hospital MACE After Primary Percutaneous Coronary Intervention for Acute ST-Segment Elevation
Zu-Fei Wu1, Wen-Tao Su2,3, Shi Chen4
1Department of Cardiology, Xuancheng People's Hospital, Xuanchen, Anhui, 242000, People's Republic of China.
Insights
Serum parathyroid hormone (PTH) levels correlate with major adverse cardiovascular events (MACE) in ST-segment elevation myocardial infarction (STEMI) patients post-PCI. A new PTH-based nomogram model shows strong predictive value for in-hospital MACE.
Area of Science:
- Cardiology
- Endocrinology
- Biomarkers
Background:
- Acute ST-segment elevation myocardial infarction (STEMI) poses significant cardiovascular risk.
- Identifying reliable predictors for in-hospital major adverse cardiovascular events (MACE) post-primary percutaneous coronary intervention (PCI) is crucial.
- The role of serum parathyroid hormone (PTH) in STEMI outcomes requires further investigation.
Purpose of the Study:
- To examine the association between serum PTH levels and in-hospital MACE in STEMI patients undergoing primary PCI.
- To develop and validate a risk prediction model for in-hospital MACE incorporating PTH levels.
Main Methods:
- Observational retrospective study of 340 STEMI patients undergoing primary PCI.
- Correlation and multivariate logistic regression analyses to identify risk factors for MACE.
- Development of a nomogram using Least Absolute Shrinkage and Selection Operator (LASSO) regression and validated with C-index and calibration curves.
Main Results:
- Serum PTH levels showed a positive correlation with in-hospital MACE.
- PTH demonstrated good predictive value for MACE.
- A nomogram model incorporating PTH, Killip class II-IV, and Fasting Blood Glucose (FBG) showed a C-index of 0.894 and superior clinical utility compared to the TIMI score.
Conclusions:
- Serum PTH levels are associated with in-hospital MACE in STEMI patients post-primary PCI.
- The developed nomogram risk prediction model, including PTH, offers valuable clinical utility for predicting MACE.
Objective:
To investigate the correlation between serum parathyroid hormone (PTH) levels and in-hospital major adverse cardiovascular events (MACE) in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI), and establish a risk prediction model based on parameters such as PTH for in-hospital MACE.
Methods:
This observational retrospective study consecutively enrolled 340 patients who underwent primary PCI for STEMI between January 2016 and December 2020, divided into a MACE group (n=92) and a control group (n=248). The least absolute shrinkage and selection operator (LASSO) and logistic regression analyses were used to determine the risk factors for MACE after primary PCI. The rms package in R-studio statistical software was used to construct a nomogram, to detect the line chart C-index, and to draw a calibration curve. The decision curve analysis (DCA) method was used to evaluate the clinical application value and net benefit.
Results:
Correlation analysis revealed that PTH level positively correlated with the occurrence of in-hospital MACE. Receiver operating characteristic curve analyses revealed that PTH had a good predictive value for in-hospital MACE. Multivariate logistic regression analysis indicated that Killip class II-IV, and FBG were independently associated with in-hospital MACE after primary PCI. A nomogram model was constructed using the above parameters. The model C-index was 0.894 and the calibration curve indicated that the model was well calibrated. The DCA curve suggested that the nomogram model was better than TIMI score model in terms of net clinical benefit.
Conclusion:
Serum PTH levels in patients with STEMI are associated with in-hospital MACE after primary PCI, and the nomogram risk prediction model based on PTH demonstrated good predictive ability with obvious clinical practical value.
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