Background
Methods
Patients
Data collection
Research registration
Creation of new model
Statistical analysis
Outcome endpoint
Results
Demographic data
Variables | Total (n = 1887) | cTnT group (n = 971) | hs-cTnT group (n = 916) | P |
---|---|---|---|---|
Age (y) | 64.94 (60;71) | 65.15 (60;71) | 64.70 (60;71) | 0.413 |
Female (n, %) | 460 (24.4) | 236 (24.3) | 224 (24.5) | 0.940 |
Weight (kg) | 68.88 (61;69) | 69.14 (61;76) | 68.61 (60;75) | 0.115 |
Height (cm) | 166.52 (160;172) | 166.53 (160;172) | 166.51 (160;172) | 0.851 |
BMI (kg/m2) | 24.79 (22.83;26.67) | 24.89 (22.86;26.85) | 24.69 (22.66;26.52) | 0.066 |
BSA (m2) | 1.74 (1.63;1.85) | 1.75 (1.63;1.86) | 1.74 (1.62;1.84) | 0.226 |
Diabetes (n, %) | 590 (31.3) | 324 (33.4) | 266 (29.0) | 0.043 |
Hypertention (n, %) | 1281 (68.4) | 722 (74.4) | 569 (62.1) | 0.000 |
Cr (μmol/l) | 82.44 (64.80;90.10) | 83.99 (68.00;91.90) | 80.79 (62.43;86.00) | 0.000 |
Ccr (mL/min/1.73 m2) | 80.87 (63.31;95.83) | 78.69 (62.17;93.39) | 83.16 (64.86;99.32) | 0.000 |
Renal failure (n, %) | 29 (1.5) | 11 (1.1) | 18 (2.0) | 0.236 |
Myocardial injury classification | 0.212 | |||
Stage 1 (n, %) | 1322 (70.1) | 894 (92.1) | 428 (46.7) | |
Stage 2 (n, %) | 455 (24.1) | 66 (6.8) | 389 (42.5) | |
Stage 3 (n, %) | 45 (2.4) | 6 (0.6) | 39 (4.3) | |
Stage 4 (n, %) | 65 (3.4) | 5 (0.5) | 60 (6.6) | |
Cerebrovascular disease (n, %) | 350 (18.5) | 254 (26.2) | 96 (10.5) | 0.100 |
COPD (n, %) | 54 (2.9) | 21 (2.2) | 33 (3.6) | 0.311 |
Peripheral vascular disease (n, %) | 47 (2.5) | 30 (3.1) | 17 (1.9) | 0.517 |
Previous PCI (n, %) | 115 (6.1) | 31 (3.2) | 84 (9.2) | 0.296 |
Atrial flutter and fibrillation (n, %) | 66 (3.5) | 34 (3.5) | 32 (3.5) | 0.385 |
Combined valvular disease (n, %) | 249 (13.2) | 71 (7.3) | 178 (19.4) | 0.001 |
Pulmonary hypertension (n, %) | 179 (9.5) | 21 (2.2) | 158 (17.2) | 0.177 |
Types of CAD | 0.000 | |||
AMI (n, %) | 260 (13.8) | 161 (16.6) | 99 (10.8) | |
Unstable angina (n, %) | 1028 (54.5) | 567 (58.4) | 461 (50.3) | |
Number of diseased vessels (n) | 2.85 (3;3) | 2.85 (3;3) | 2.85 (3;3) | 0.459 |
NYHA | 0.002 | |||
I (n, %) | 217 (31.7) | 67 (6.9) | 150 (16.4) | |
II (n, %) | 1229 (65.1) | 684 (70.4) | 545 (59.5) | |
III (n, %) | 404 (21.4) | 202 (20.8) | 202 (22.1) | |
IV (n, %) | 37 (2) | 18 (1.9) | 19 (2.1) | |
LVEF (%) | 60.92 (59.9;65.4) | 61.75 (60.0;65.9) | 60.03 (58.0;65.2) | 0.000 |
EuroSCORE II | 1.68 (0.94;2.03) | 1.82 (1.01;2.22) | 1.53 (0.85;1.80) | 0.000 |
Bypass graft number (n) | 3.54 (3;4) | 3.54 (3;4) | 3.55 (3;4) | 0.444 |
In-hospital mortality (n, %) | 43 (2.3) | 21 (2.2) | 22 (2.4) | 0.155 |
Variables | Stable group (n = 599) | Unstable group (n = 1028) | AMI group (n = 260) | P |
---|---|---|---|---|
Age (y) | 64.62 (59;71) | 65.34 (61;71) | 64.06 (59;70) | 0.052 |
Female (n, %) | 119 (19.9) | 278 (27.0) | 63 (24.2) | 0.005 |
Weight (kg) | 69.45 (62;76) | 68.75 (60;75) | 68.11 (61;74) | 0.154 |
Height (cm) | 167.12 (162.00;172.00) | 166.15 (160.00;171.00) | 166.60 (160.25;171.75) | 0.053 |
BMI (kg/m2) | 24.83 (22.89;26.84) | 24.85 (22.84;26.77) | 24.49 (22.54;25.92) | 0.105 |
BSA (m2) | 1.76 (1.64;1.87) | 1.74 (1.62;1.85) | 1.74 (1.63;1.83) | 0.155 |
Diabetes (n, %) | 149 (24.9) | 352 (34.2) | 89 (34.2) | 0.000 |
Hypertention (n, %) | 364 (60.8) | 743 (72.3) | 184 (70.8) | 0.000 |
Cr (μmol/l) | 83.25 (64.60;90.20) | 81.82 (64.50;89.58) | 83.02 (67.78;91.73) | 0.164 |
Ccr (mL/min/1.73 m2) | 82.28 (65.12;91.06) | 81.12 (62.53;95.94) | 79.14 (62.35;90.86) | 0.076 |
Renal failure (n, %) | 7 (1.2) | 17 (1.7) | 5 (1.9) | 0.642 |
Myocardial injury classification | 0.000 | |||
Stage 1 (n, %) | 414 (69.1) | 767 (74.6) | 141 (54.2) | |
Stage 2 (n, %) | 160 (26.7) | 217 (21.1) | 78 (30.0) | |
Stage 3 (n, %) | 9 (1.5) | 17 (1.7) | 19 (7.3) | |
Stage 4 (n, %) | 16 (2.7) | 27 (2.6) | 22 (8.5) | |
Cerebrovascular disease (n, %) | 81 (13.5) | 221 (21.5) | 48 (18.5) | 0.000 |
COPD (n, %) | 18 (3.0) | 27 (2.6) | 9 (3.5) | 0.746 |
Peripheral vascular disease (n, %) | 17 (2.8) | 23 (2.2) | 7 (2.7) | 0.736 |
Previous PCI (n, %) | 22 (3.7) | 76 (7.4) | 17 (6.5) | 0.010 |
Atrial flutter and fibrillation (n, %) | 14 (2.3) | 40 (3.9) | 12 (4.6) | 0.148 |
Combined valvulardisease (n, %) | 138 (23.0) | 67 (6.5) | 44 (16.9) | 0.000 |
Pulmonary hypertension (n, %) | 69 (11.6) | 83 (8.1) | 27 (10.4) | 0.063 |
Number of diseased vessels (n) | 2.84 (3;3) | 2.85 (3;3) | 2.87 (3;3) | 0.683 |
NYHA | 0.000 | |||
I (n, %) | 68 (11.4) | 109 (10.6) | 40 (15.4) | |
II (n, %) | 402 (67.1) | 691 (67.2) | 136 (52.3) | |
III (n, %) | 122 (20.4) | 212 (20.6) | 70 (26.9) | |
IV (n, %) | 7 (1.2) | 16 (1.6) | 14 (5.4) | |
LVEF (%) | 61.45 (60.10;65.60) | 61.32 (60.00;65.78) | 58.09 (52.27;64.40) | 0.000 |
EuroSCORE II | 1.44 (1.21;1.79) | 1.73 (0.95;2.10) | 2.02 (0.96;2.47) | 0.000 |
Bypass graft number (n) | 3.69 (3;4) | 3.44 (3;4) | 3.60 (3;4) | 0.000 |
In-hospital mortality (n, %) | 14 (2.3) | 19 (1.8) | 10 (3.8) | 0.155 |
Perioperative outcomes
ROC curve
H–L | AUC | 95%CI (%) | P | H–L | AUC | 95%CI (%) | P | H–L | AUC | 95%CI (%) | P | H–L | AUC | 95%CI (%) | P | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Total cohort (n = 1887) | SA group (n = 599) | UA group (n = 1028) | AMI group (n = 260) | |||||||||||||
Euroscore II | 0.121 | 0.746 | 0.684–0.808 | 0.000 | 0.223 | 0.727 | 0.641–0.813 | 0.004 | 0.987 | 0.765 | 0.670–0.860 | 0.000 | 0.193 | 0.772 | 0.619–0.925 | 0.004 |
New evaluation system | 0.326 | 0.771 | 0.702–0.840 | 0.000 | 0.133 | 0.831 | 0.742–0.921 | 0.000 | 0.870 | 0.690 | 0.568–0.813 | 0.004 | 0.071 | 0.813 | 0.709–0.918 | 0.001 |
H–L | AUC | 95%CI (%) | P | H–L | AUC | 95%CI (%) | P | H–L | AUC | 95%CI (%) | P | H–L | AUC | 95%CI (%) | P | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
cTnT group (n = 971) | SA group (n = 243) | UA group (n = 567) | AMI group (n = 161) | |||||||||||||
Euroscore II | 0.407 | 0.769 | 0.676–0.862 | 0.000 | 0.384 | 0.699 | 0.494–0.904 | 0.332 | 0.959 | 0.725 | 0.587–0.863 | 0.070 | 0.437 | 0.841 | 0.717–0.966 | 0.002 |
New evaluation system | 0.507 | 0.774 | 0.668–0.879 | 0.000 | 0.810 | 0.724 | 0.497–0.951 | 0.275 | 0.369 | 0.699 | 0.550–0.848 | 0.018 | 0.485 | 0.906 | 0.820–0.992 | 0.000 |
H–L | AUC | 95%CI (%) | P | H–L | AUC | 95%CI (%) | P | H–L | AUC | 95%CI (%) | P | H–L | AUC | 95%CI (%) | P | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
hs-cTnT group (n = 916) | SA group (n = 356) | UA group (n = 461) | AMI group (n = 99) | |||||||||||||
Euroscore II | 0.272 | 0.747 | 0.671–0.822 | 0.000 | 0.054 | 0.762 | 0.672–0.852 | 0.002 | 0.893 | 0.822 | 0.703–0.941 | 0.003 | 0.060 | 0.646 | 0.344–0.947 | 0.391 |
New evaluation system | 0.405 | 0.782 | 0.694–0.869 | 0.000 | 0.132 | 0.849 | 0.794–0.905 | 0.000 | 0.664 | 0.736 | 0.490–0.982 | 0.032 | 0.699 | 0.715 | 0.456–0.975 | 0.206 |
Net reclassification index
NRI (%) | 95% CI (%) | P | |
---|---|---|---|
Total EuroSCORE II versus new evaluation system | − 11.24 | − 25.10–2.62 | 0.06 |
Grouped by types of cTnT | |||
cTnT EuroSCORE II versus new evaluation system | − 9.85 | − 32.39–12.71 | 0.20 |
hs-cTnT EuroSCORE II versus new evaluation system | − 19.44 | − 38.17–-0.72 | 0.04 |
Grouped by types of CAD | |||
Stable angina EuroSCORE II versus new evaluation system | − 11.90 | − 30.31–6.53 | 0.12 |
Unstable angina EuroSCORE II versus new evaluation system | − 24.54 | − 49.19–0.12 | 0.04 |
AMI EuroSCORE II versus new evaluation system | 17.20 | − 1.99–36.39 | 0.95 |
Bland–Altman analysis
Logistic regression analysis
Variables | Total cohort (n = 1887) | cTnT group (n = 971) | hs-cTnT group (n = 916) | ||||||
---|---|---|---|---|---|---|---|---|---|
OR | 95%CI | P | OR | 95%CI | P | OR | 95%CI | P | |
Age (y) | 1.052 | 1.012–1.094 | 0.011 | 1.055 | 0.997–1.116 | 0.064 | 1.049 | 0.994–1.108 | 0.080 |
Female (n, %) | 1.513 | 0.793–2.889 | 0.209 | 1.252 | 0.480–3.265 | 0.646 | 1.794 | 0.742–4.333 | 0.194 |
Weight (kg) | 0.985 | 0.957–1.014 | 0.310 | 0.982 | 0.942–1.024 | 0.395 | 0.988 | 0.949–1.029 | 0.563 |
Height (cm) | 0.984 | 0.945–1.024 | 0.422 | 0.965 | 0.911–1.022 | 0.223 | 1.001 | 0.946–1.060 | 0.961 |
NYHA classification (n, %) | 2.425 | 1.562–3.766 | 0.000 | 2.552 | 1.329–4.901 | 0.005 | 2.321 | 1.286–4.191 | 0.005 |
Types of CAD (n, %) | 1.231 | 0.776–1.951 | 0.377 | 2.256 | 1.129–4.509 | 0.021 | 0.720 | 0.363–1.427 | 0.347 |
Hypertention (n, %) | 0.859 | 0.455–1.620 | 0.638 | 2.097 | 0.612–7.179 | 0.238 | 0.499 | 0.213–1.169 | 0.109 |
Diabetes (n, %) | 1.450 | 0.781–2.694 | 0.239 | 1.512 | 0.630–3.626 | 0.354 | 1.409 | 0.584–3.398 | 0.446 |
Cerebrovascular disease (n, %) | 0.210 | 0.050–0.871 | 0.032 | 0.292 | 0.067–1.261 | 0.099 | 0.000 | 0.000–0.000 | 0.997 |
Cr (μmol/l) | 1.004 | 1.001–1.007 | 0.013 | 1.005 | 1.000–1.010 | 0.069 | 1.003 | 1.000–1.007 | 0.076 |
Ccr (ml/min/1.73 m2) | 0.975 | 0.962–0.988 | 0.000 | 0.971 | 0.951–0.991 | 0.005 | 0.978 | 0.961–0.995 | 0.010 |
LVEF (%) | 0.934 | 0.908–0.961 | 0.000 | 0.926 | 0.083–0.970 | 0.001 | 0.938 | 0.904–0.974 | 0.001 |
Number of diseased vessels (n) | 1.071 | 0.539–2.126 | 0.845 | 2.542 | 0.426–15.184 | 0.306 | 0.757 | 0.362–1.585 | 0.461 |
Peripheral vascular disease (n, %) | 4.296 | 1.470–12.556 | 0.008 | 3.466 | 0.770–15.608 | 0.105 | 5.86 | 1.256–27.349 | 0.024 |
Emergency operation (n, %) | 6.096 | 2.602–14.284 | 0.000 | 11.143 | 2.943–42.187 | 0.000 | 4.398 | 1.427–13.559 | 0.010 |
Combined valvulardisease (n, %) | 0.669 | 0.237–1.890 | 0.448 | 0.629 | 0.083–4.753 | 0.653 | 0.649 | 0.190–2.217 | 0.490 |
COPD (n, %) | 0.805 | 0.109–5.956 | 0.831 | 0.000 | 0.000–0.000 | 0.998 | 1.283 | 0.167–9.834 | 0.811 |
Atrial flutter and fibrillation (n, %) | 0.652 | 0.088–4.808 | 0.674 | 1.389 | 0.181–10.666 | 0.752 | 0.000 | 0.000–0.000 | 0.998 |
Pulmonary hypertension (n, %) | 0.978 | 0.345–2.769 | 0.967 | 0.000 | 0.000–0.000 | 0.998 | 1.068 | 0.356–3.199 | 0.907 |
Previous PCI (n, %) | 1.601 | 0.562–4.561 | 0.378 | 1.533 | 0.199–11.804 | 0.681 | 1.585 | 0.459–5.470 | 0.466 |
BMI (kg/m2) | 0.960 | 0.870–1.060 | 0.424 | 0.988 | 0.860–1.135 | 0.864 | 0.934 | 0.810–1.077 | 0.348 |
Renal failure (n, %) | 9.978 | 3.614–27.551 | 0.000 | 11.006 | 2.226–54.407 | 0.003 | 9.253 | 2.471–34.646 | 0.001 |
Euroscore II (%) | 1.574 | 1.342–1.846 | 0.000 | 1.815 | 1.414–2.330 | 0.000 | 1.437 | 1.166–1.770 | 0.001 |
Myocardial injury classification (n, %) | 2.049 | 1.542–2.722 | 0.000 | 3.564 | 2.105–6.035 | 0.000 | 1.963 | 1.322–2.915 | 0.001 |
Variables | Total cohort (n = 1887) | cTnT group (n = 971) | hs-cTnT group (n = 916) | ||||||
---|---|---|---|---|---|---|---|---|---|
OR | 95%CI | P | OR | 95%CI | P | OR | 95%CI | P | |
Age (y) | 1.021 | 0.973–1.071 | 0.403 | 1.001 | 0.924–1.805 | 0.977 | 1.032 | 0.967–1.101 | 0.344 |
Female (n, %) | 1.123 | 0.536–2.353 | 0.758 | 0.883 | 0.296–2.640 | 0.824 | 1.595 | 0.543–4.682 | 0.396 |
NYHA classification (n, %) | 1.540 | 0.936–2.535 | 0.089 | 1.198 | 0.530–2.659 | 0.677 | 1.870 | 0.933–3.749 | 0.078 |
Cerebrovascular disease (n, %) | 0.179 | 0.042–0.774 | 0.021 | 0.202 | 0.044–0.920 | 0.039 | 0.000 | 0.000–0.000 | 0.996 |
Ccr (mL/min/1.73 m2) | 0.995 | 0.977–1.012 | 0.551 | 0.992 | 0.965–1.020 | 0.567 | 1.002 | 0.979–1.026 | 0.851 |
LVEF (%) | 0.959 | 0.977–1.012 | 0.551 | 0.953 | 0.893–1.016 | 0.140 | 0.954 | 0.910–1.000 | 0.049 |
Peripheral vascular disease (n, %) | 3.099 | 0.954–10.066 | 0.060 | 2.176 | 0.398–11.903 | 0.370 | 3.579 | 0.607–21.117 | 0.159 |
Emergency operation (n, %) | 3.256 | 1.115–9.506 | 0.031 | 0.549 | 0.029–10.402 | 0.689 | 5.232 | 1.449–18.885 | 0.012 |
Renal failure (n, %) | 2.016 | 0.443–9.170 | 0.364 | 0.627 | 0.040–9.701 | 0.738 | 5.681 | 0.793–40.713 | 0.084 |
Myocardial injury classification (n, %) | 1.491 | 1.049–2.119 | 0.026 | 2.421 | 1.030–5.689 | 0.042 | 1.761 | 1.102–2.814 | 0.018 |
EuroSCORE II (%) | 1.310 | 1.045–1.643 | 0.019 | 1.544 | 1.015–2.349 | 0.043 | 1.273 | 0.879–1.844 | 0.201 |
Hypertension (n, %) | 0.823 | 0.406–1.669 | 0.589 | 1.889 | 0.502–7.108 | 0.347 | 0.482 | 0.185–1.256 | 0.135 |
Diabetes (n, %) | 1.259 | 0.634–2.498 | 0.511 | 1.709 | 0.653–4.475 | 0.275 | 0.871 | 0.310–2.444 | 0.793 |
Combined valvulardisease (n, %) | 0.388 | 0.125–1.199 | 0.100 | 0.273 | 0.031–2.392 | 0.241 | 0.326 | 0.079–1.345 | 0.121 |
BMI (kg/m2) | 0.996 | 0.884–1.123 | 0.949 | 0.992 | 0.830–1.184 | 0.925 | 0.984 | 0.823–1.176 | 0.859 |