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冠状动脉旁路移植与冠状动脉内关节切除术相结合后的风险预测
Wei Zhao1, Xieraili Tiemuerniyazi1, Ziang Yang1
1Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
The American journal of cardiology
|June 16, 2023
概括
在冠状动脉旁路移植加上内关节切除术 (CABG+CE) 后,一个新的诺米图预测主要的不良心血管和脑血管事件 (MACCE). 该工具有助于评估经过复杂的再血管化手术的患者的1年和3年风险.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 医学统计 医学统计
背景情况:
- 冠状动脉内切除术 (CE) 与冠状动脉旁路移植 (CABG) 结合,用于在扩散性冠状动脉疾病中进行完整的再血管化.
- 这种联合程序与风险增加有关,需要有效的风险预测策略.
研究的目的:
- 在接受CABG + CE的患者中开发和验证主要心血管和脑血管不良事件 (MACCE) 的预测模型.
- 在这个患者群体中确定MACCE的关键预测因子.
主要方法:
- 在2008年9月至2022年7月期间接受CABG + CE的570名患者的回顾性分析.
- 最小绝对收缩和选择运算符 (LASSO) 回归用于特征选择.
- 多变量考克斯回归用于开发用于预测1年和3年MACCE的名图.
主要成果:
- 确定了四种MACCE的显著预测因素:年龄≥65岁,左侧主疾病,额头回 (≥轻度) 和左前下降内关节切除术.
- 开发的名图表显示出良好的区别 (C指数为0.68) 和校准,用于预测MACCE.
- 诺米图提供了CABG+CE后1年和3年MACCE风险的估计.
结论:
- 开发的诺米图是估计CABG+CE患者MACCE风险的一个有价值的工具.
- 已识别的预测因素可以帮助分层患者的风险,并指导临床决策.
- 需要进一步的验证和前性研究来证实这种风险预测模型的临床实用性.
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