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穿皮冠状动脉干预后主要心血管不良事件的预测模型:系统性审查

Wenqi Deng¹, Dayang Wang^1,2, Yandi Wan¹

¹Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.

Frontiers in cardiovascular medicine

|January 23, 2024

概括

穿皮冠状动脉干预后主要不良心血管事件的预测模型显示出一些能力,但存在高偏差. 为了更好的临床应用,需要改进方法.

科学领域:

心脏病学心脏病学
医疗信息学医疗信息学
生物统计学生物统计学

背景情况:

许多模型预测皮肤穿刺冠状动脉干预 (PCI) 后的主要不良心血管事件 (MACE).
这些现有的MACE预测模型的临床性能和可靠性在很大程度上是未知的.
系统审查对于评估和比较这些模型至关重要.

研究的目的:

系统地评估,描述和比较现有的MACE预测模型,用于接受PCI的患者.
确定有效预测患者群体中心血管结果的关键因素.
评估当前MACE预测模型的质量和透明度.

主要方法:

遵守PRISMA 2020系统审查指南.
在多个数据库 (Embase,PubMed等) 中进行全面的文献搜索. 从1977年开始到2023年5月.
包括具有或没有外部验证的模型开发研究,使用PROBAST和TRIPOD标准进行评估.

主要成果:

从5234篇获取的文章中,包括了23项研究,主要关注ST段升高心肌梗塞 (STEMI) 患者.
模型歧视 (AUC/C指数) 从0.638到0.96不等,常见的预测因素包括LVEF,年龄,Killip类和糖尿病.
所有评估的模型都表现出高偏差风险,尽管超过60%的人报告遵守TRIPOD指南.

结论:

现有的MACE预测模型展示了一些预测能力,但由于偏差风险高,它们受到显著限制.
方法上的缺陷需要遵守开发指南,以提高模型质量.
加强模型开发对于可靠的临床决策和更广泛的传播至关重要.

关键词:

临床预测模型的临床预测模型.主要的不良心血管事件.通过皮肤进行冠状动脉干预.预后预后预后系统性审查系统性审查

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