心脏代谢指数与PCI后冠状动脉微血管功能障碍在急性STEMI患者之间的关系
Xiang Sha1, Wei Wang1, Jian Wang1
1Department of Cardiology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, People's Republic of China.
Journal of multidisciplinary healthcare
|September 15, 2025
概括
较高的心脏代谢指数 (CMI) 与ST段升高心肌梗塞 (STEMI) 患者的冠状动脉微血管功能障碍 (CMD) 有关. 将CMI集成到随机森林模型中可以改善CMD预测.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 生物统计学 生物统计学
背景情况:
- 冠状动脉微血管功能障碍 (CMD) 在穿皮冠状动脉干预 (PCI) 后对ST段升高心肌梗塞 (STEMI) 患者的结果产生负面影响.
- 心脏代谢指数 (CMI) 是脂质和人体参数的复合标记,与心血管风险有关,但其在PCI后心血管疾病中的作用尚不清楚.
研究的目的:
- 调查CMI与PCI接受STEMI患者中CMD发病率之间的关联.
- 用机器学习方法评估CMI对PCI后CMD的预测能力.
主要方法:
- 对702名接受初级PCI和随后的微血管功能评估的STEMI患者进行了回顾性队列研究.
- 根据非侵入性微血管抵抗指数,患者被分为CMD和非CMD组.
- 我们使用了后勤回归,受限立方线分析和机器学习模型 (随机森林,LightGBM,XGboost,K-Nearest Neighbors).
主要成果:
- 在52.1%的患者中存在CMD;较高的CMI三位数 (T2,T3) 与T1相比显著增加了CMD的几率 (aOR分别为2.41和3.40).
- 在CMI和CMD之间观察到非线性关系 (P < 0.001).
- 随机森林模型显示了CMD的最高预测性能 (AUC = 0.772),CMI通过夏普利分析被确定为关键预测因子.
结论:
- 升高的CMI是PCI后STEMI患者中发展CMD的独立风险因素.
- 当被纳入随机森林机器学习模型时,CMD的CMI的预测价值会得到增强.
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