Background
Methods
Patient selection
Experimental design
Outcome measures
Quality control of data entry
Statistical analysis
Results
Determination of independent risk factors for the in-hospital prognosis of STEMI patients after PCI
Variable | Assigned value |
---|---|
Prognosis | Good = 0; Poor = 1 |
Gender | Male = 1; Female = 2 |
Age (years) | < 45 = 0; 45–59 = 1; ≥ 60 = 2 |
Cardiac function at admission | I = 0; II = 1; III = 2; IV = 3 |
Hyperlipidemia | Yes = 0; No = 1 |
Complications | Yes = 0; No = 1 |
SBP | ≤ 90 = 0; 91–139 = 1; ≥ 140 = 2 |
DBP | < 60 = 0; ≥ 60 = 1 |
HR | < 75 = 0; 75–94 = 1; ≥ 95 = 2 |
History of hypertension | Yes = 0; No = 1 |
History of diabetes | Yes = 0; No = 1 |
History of stroke | Yes = 0; No = 1 |
Family medical history | Yes = 0; No = 1 |
WBC count (×109/L) | < 4 = 0; 4–10 = 1; > 10 = 2 |
Neutral leaf granulocyte count (×109/L) | < 1.8 = 0; 1.8–6.4 = 1; > 6.4 = 2 |
Neural leaf granulocyte percentage (%) | < 0.46 = 0; 0.46–0.75 = 1; > 0.75 = 2 |
Hemoglobin (g/L) | < 120 = 0; 120–160 = 1; > 160 = 2 |
PLT (×109/L) | < 100 = 0; 100–300 = 1; > 300 = 2 |
K+ (mM) | < 3.5 = 0; 3.5–5.3 = 1; > 5.3 = 2 |
Na+ (mM) | < 135 = 0; 135–145 = 1; > 145 = 2 |
Cl− (mM) | < 96 = 0; 96–110 = 1; > 110 = 2 |
Ca2+ (mM) | < 2.1 = 0; 2.1–2.6 = 1; > 2.6 = 2 |
GLU (mM) | ≤ 6.0 = 0; > 6.0 = 1 |
Creatinin (μM) | < 53 = 0; 53–115 = 1; > 115 = 2 |
Urea nitrogen (mM) | < 2.9 = 0; 2.9–8.6 = 1; > 8.6 = 2 |
Uric acid (μM) | < 142 = 0; 142–452 = 1; > 452 = 2 |
TC (mM) | < 3.1 = 0; 3.1–5.7 = 1; > 5.7 = 2 |
TG (mM) | ≤ 1.7 = 0; > 1.7 = 1 |
HDL-c (mM) | < 1.09 = 0; 1.09–1.63 = 1; > 1.63 = 2 |
LDL-c (mM) | < 3.61 = 0; > 3.61 = 1 |
APo-E (mg/L) | < 27 = 0; 27–45 = 1; > 45 = 2 |
Lp-a (mg/L) | ≤ 300 = 0; > 300 = 1 |
Hs-CRP (mg/L) | < 0.1 = 0; 0.1–3 = 1; > 3 = 2 |
CK-MB (ng/mL) | ≤ 4.94 = 0; > 4.94 = 1 |
c-TnT (ng/mL) | ≤ 0.1 = 0; > 0.1 = 1 |
BNP (ng/L) | ≤ 84 = 0; > 84 = 1 |
PT (s) | < 11 = 0; 11–14 = 1; > 14 = 2 |
APTT (s) | < 25 = 0; 25–35 = 2; > 35 |
TT (s) | < 14 = 0; 14–21 = 1; > 21 = 2 |
Fbg (g/L) | < 2 = 0; 2–4 = 1; > 4 = 2 |
D-Dimer (μg/L) | ≤ 300 = 0; > 300 = 1 |
Outcome measures | n | Poor prognosis (n) (%) | χ2
|
P
|
---|---|---|---|---|
Gender | ||||
Male | 611 | 49 (8.0) | 0.973 | 0.324 |
Female | 90 | 10 (11.1) | ||
Age (years) | ||||
< 45 | 52 | 4 (7.7) | 7.249 | 0.027* |
45–59 | 276 | 14 (5.1) | ||
≥ 60 | 373 | 41 (11.0) | ||
Admission diagnosis | ||||
cardiac function | ||||
Grade I | 452 | 3 (0.7) | 601.143 | <0.001** |
Grade II | 190 | 1 (0.5) | ||
Grade III | 34 | 32 (94.1) | ||
Grade IV | 25 | 23 (92.0) | ||
Hyperlipidemia | ||||
Yes | 108 | 7 (8.8) | 0.620 | 0.431 |
No | 593 | 52 (11.9) | ||
Complications | ||||
Yes | 137 | 19 (13.9) | 6.426 | 0.011* |
No | 560 | 40 (7.1) | ||
SBP (mmHg) | ||||
≤ 90 | 21 | 1 (4.8) | 27.210 | <0.001** |
91–139 | 518 | 37 (7.1) | ||
≥ 140 | 153 | 21 (13.7) | ||
DBP (mmHg) | ||||
< 60 | 82 | 18 (22.0) | 21.688 | <0.001** |
≥ 60 | 613 | 41 (6.7) | ||
HR (beats/min) | ||||
< 75 | 342 | 17 (5.0) | 34.651 | <0.001** |
75–94 | 268 | 21 (7.8) | ||
≥ 95 | 79 | 20 (25.3) | ||
Past history and family disease | ||||
Hypertension | ||||
Yes | 299 | 29 (9.7) | 1.112 | 0.292 |
No | 402 | 30 (7.5) | ||
Diabetes | ||||
Yes | 175 | 23 (13.1) | 6.759 | 0.009** |
No | 526 | 36 (6.8) | ||
Stroke | ||||
Yes | 15 | 1 (6.7) | 0.061 | 0.805 |
no | 686 | 58 (8.5) | ||
Family medical history | ||||
Yes | 154 | 14 (9.1) | 0.116 | 0.733 |
No | 547 | 45 (8.2) | ||
MI index | ||||
CK-MB (ng/mL) | ||||
≤ 4.94 | 354 | 22 (6.2) | 4.362 | 0.037* |
> 4.94 | 329 | 35 (10.6) | ||
c-TnT (ng/mL) | ||||
≤ 0.1 | 124 | 13 (10.5) | 0.539 | 0.463 |
> 0.1 | 477 | 40 (8.4) | ||
BNP (ng/L) | ||||
≤ 84 | 36 | 2 (5.6) | 0.408 | 0.523 |
> 84 | 593 | 51 (8.6) | ||
Blood test | ||||
WBC count (×109/L) | ||||
< 4 | 8 | 1 (12.5) | 12.749 | 0.002** |
4–10 | 420 | 23 (5.5) | ||
> 10 | 264 | 35 (13.3) | ||
NLG count (×109/L) | ||||
< 1.8 | 2 | 0 (0.0) | 6.235 | 0.044* |
1.8–6.4 | 373 | 23 (6.2) | ||
> 6.4 | 315 | 36 (11.4) | ||
NLG proportion (%) | ||||
< 0.46 | 22 | 4 (18.2) | 18.619 | <0.001** |
0.46–0.75 | 476 | 26 (5.5) | ||
> 0.75 | 194 | 29 (14.9) | ||
Hemoglobin (g/L) | ||||
< 120 | 123 | 19 (15.4) | 9.200 | 0.010** |
120–160 | 529 | 37 (7.0) | ||
> 160 | 40 | 3 (7.5) | ||
PLT (×109/L) | ||||
< 100 | 8 | 1 (12.5) | 0.165 | 0.921 |
100–300 | 543 | 46 (8.5) | ||
> 300 | 142 | 12 (8.5) | ||
Blood biomedical test | ||||
K+ (mM) | ||||
< 3.5 | 43 | 5 (11.6) | 18.528 | <0.001** |
3.5–5.3 | 639 | 50 (7.8) | ||
> 5.3 | 8 | 4 (50.0) | ||
Na+ (mM) | ||||
< 135 | 94 | 12 (16.0) | 8.985 | 0.011* |
135–145 | 584 | 42 (7.2) | ||
> 145 | 12 | 2 (16.7) | ||
Cl− (mM) | ||||
< 96 | 26 | 7 (26.9) | 11.967 | 0.003** |
96–110 | 650 | 50 (7.7) | ||
> 110 | 11 | 1 (9.1) | ||
Ca2+ (mM) | ||||
< 2.1 | 150 | 20 (13.3) | 6.311 | 0.043* |
2.1–2.6 | 501 | 36 (7.2) | ||
> 2.6 | 5 | 1 (20.0) | ||
GLU (mM) | ||||
≤ 6.0 | 313 | 18 (5.8) | 5.743 | 0.017* |
> 6.0 | 377 | 41 (10.9) | ||
Creatinine (μM) | ||||
< 53 | 18 | 3 (16.7) | 40.809 | <0.001** |
53–115 | 589 | 34 (5.8) | ||
> 115 | 84 | 22 (26.2) | ||
Urea nitrogen (mM) | ||||
< 2.9 | 24 | 2 (8.3) | 57.631 | <0.001** |
2.9–8.6 | 591 | 35 (5.9) | ||
> 8.6 | 65 | 22 (33.8) | ||
Uric acid (μM) | ||||
< 142 | 7 | 1 (14.3) | 28.333 | <0.001** |
142–452 | 397 | 22 (5.5) | ||
> 452 | 63 | 16 (25.4) | ||
TC (mM) | ||||
< 3.1 | 55 | 5 (9.1) | 0.258 | 0.879 |
3.1–5.7 | 467 | 35 (7.5) | ||
> 5.7 | 102 | 7 (6.7) | ||
TG (mM) | ||||
≤ 1.7 | 460 | 37 (8.1) | 0.780 | 0.677 |
> 1.7 | 165 | 10 (6.1) | ||
HDL-c (mM) | ||||
< 1.09 | 485 | 37 (7.6) | 1.088 | 0.580 |
1.09–1.63 | 127 | 10 (7.9) | ||
> 1.63 | 13 | 0 (0.0) | ||
LDL-c (mM) | ||||
< 3.61 | 462 | 37 (7.9) | 0.765 | 0.682 |
> 3.61 | 162 | 10 (6.2) | ||
APo-E (mg/L) | ||||
< 27 | 379 | 29 (7.7) | 1.939 | 0.379 |
27–45 | 23 | 0 (0.0) | ||
> 45 | 202 | 16 (7.7) | ||
Lp-a (mg/L) | ||||
≤ 300 | 261 | 24 (9.2) | 2.218 | 0.330 |
> 300 | 341 | 21 (6.2) | ||
Hs-CRP (mg/L) | ||||
< 0.1 | 15 | 0 (0.0) | 1.616 | 0.204 |
0.1–3 | 81 | 8 (9.9) | ||
> 3 | 96 | 8 (8.3) | ||
Coagulation | ||||
PT (s) | ||||
< 11 | 102 | 8 (7.8) | 8.572 | 0.014* |
11–14 | 504 | 39 (7.7) | ||
> 14 | 37 | 8 (21.6) | ||
APTT (s) | ||||
< 25 | 176 | 10 (5.7) | 8.470 | 0.014* |
25–35 | 396 | 33 (8.3) | ||
> 35 | 70 | 12 (17.1) | ||
TT (s) | ||||
< 14 | 65 | 5 (7.7) | 1.216 | 0.545 |
14–21 | 579 | 47 (8.1) | ||
> 21 | 57 | 7 (12.3) | ||
Fbg (g/L) | ||||
< 2 | 16 | 1 (6.3) | 0.819 | 0.664 |
2–4 | 336 | 26 (7.7) | ||
> 4 | 291 | 28 (9.6) | ||
D-Dimer (μg/L) | ||||
≤ 300 | 473 | 43 (9.1) | 0.858 | 0.354 |
> 300 | 228 | 16 (7.0) |
Relevant factor |
OR (95% CI) |
P
|
---|---|---|
History of diabetes | 2.33 (1.01, 5.36) | 0.047 |
Uric acid (μM) | ||
142–452 (normal) | 1 (reference) | |
< 142 | 0.90 (0.71, 1.15) | 0.089 |
> 452 | 1.61 (1.04, 2.10) | 0.021 |
Urea nitrogen (mM) | ||
2.9–8.6 (normal) | 1 (reference) | |
< 2.9 | 0.92 (0.68, 0.99) | 0.041 |
> 8.6 | 5.65 (1.32, 30.40) | 0.036 |
APTT (s) | ||
96–110 (normal) | 1 (reference) | |
< 96 | 0.58 (0.05, 6.25) | 0.649 |
> 110 | 2.32 (1.31, 15.36) | 0.004 |
Development and validation of the prognostic prediction model
Prognostic factor | Coefficient |
---|---|
History of diabetes (X
1) | 0.624 |
Uric acid (μM) (X
2) | 0.659 |
Urea nitrogen (mM) (X
3) | 1.988 |
APTT (s) (X
4) | 1.419 |
Constant | −4.431 |
Predictive value N (%) | Original value, n (%) | Total | |
---|---|---|---|
Good prognosis | Poor prognosis | ||
Good prognosis | 560 (87.2) | 31 (52.5) | 591 |
Poor prognosis | 82 (12.8) | 28 (47.5) | 110 |
Total | 642 (100.0) | 59 (100.0) | 701 |