摘要
目的:基于单中心数据探寻急性心肌梗死(AMI)患者新发心房颤动(房颤)的危险因素,建立列线图预测模型。方法:回顾性收集2016年1月—2019年12月因AMI住院的744例患者的临床资料,排除既往有房颤病史患者,根据住院期间是否出现新发房颤将患者分为新发房颤组(76例)和对照组(668例),通过单因素、多因素logistic回归分析新发房颤发生的独立危险因素,应用R软件建立预测新发房颤发生的列线图模型,并行模型内部验证。结果:多因素logistic逐步回归分析显示,年龄、心室率、射血分数减低、左心房内径增大是新发房颤的独立危险因素,依此构建列线图模型,评价分析示C指数为0.796(95%CI:0.742~0.850),校正曲线显示实际预测能力与理想的预测能力较为接近。结论:年龄、心室率、射血分数减低、左心房内径增大是AMI患者住院期间发生新发房颤的独立危险因素,本研究构建的列线图模型可以评估新发房颤的发生风险,具有一定的临床应用价值。
Objective:To interrogate risk factors for new-onset atrial fibrillation in patients with acute myocardial infarction based on single-center data and establish a nomogram prediction model.Methods:A total of 744 patients admitted to the hospital for acute myocardial infarction and without a history of atrial fibrillation from January 2016 to December 2019 were retrospectively collected.According to whether the patients had atrial fibrillation during their hospitalization,they were divided into the new-onset atrial fibrillation group(n=76)and the control group(n=668).Next,the independent risk factors of new-onset atrial fibrillation were analyzed by single-factor and multi-factor logistic regression analysis.Furthermore,the R software was used to establish a nomogram model for predicting the risk of new-onset atrial fibrillation,and this model was internally verified.Results:Multivariate logistic regression analysis showed that age,ventricular rate,reduced ejection fraction,and increased left atrial internal diameter were independent risk factors for new-onset atrial fibrillation.Based on this,the nomogram model was constructed,and the evaluation analysis showed that C-index was 0.796(95%CI:0.742 to 0.850).The calibration curve showed that the actual predictive ability was closer to the ideal predictive power.Conclusion:Age,heart rate,reduced ejection fraction and increased left atrial internal diameter are independent risk factors for the development of new-onset atrial fibrillation during hospitalization in AMI patients,and the nomogram model constructed in this study could evaluate the risk of the development of new-onset atrial fibrillation and has specific clinical application.
作者
毕昌龙
张侃迪
周恩
张田田
张宗棨
张俊峰
BI Changlong;ZHANG Kandi;ZHOU En;ZHANG Tiantian;ZHANG Zongqi;ZHANG Junfeng(Department of Cardiology,the Ninth People's Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai,201900,China)
出处
《临床心血管病杂志》
CAS
北大核心
2021年第8期731-735,共5页
Journal of Clinical Cardiology
基金
上海交通大学医学院附属第九人民医院生物样本库项目(No:YBKA201910)。
关键词
急性心肌梗死
心房颤动
新发
危险因素
列线图
acute myocardial infarction
atrial fibrillation
new-onset
risk factor
nomogram
