China-PAR评估为高危的急性冠脉综合征患者PCI术后再入院模型的建立与验证

Establishment and Validation of China-PAR for Evaluation of Readmission Model in Patients with Acute Coronary Syndrome after PCI

摘要: 目的：China-PAR模型已被推荐用于评估CVD 10年发病风险，但能否用于预测急性冠脉综合征患者的不良心血管事件仍不确定，本研究目前调查China-PAR模型与急性冠脉综合征PCI术后患者再入院的关系。方法：回顾性收集我院急诊科2018年至2020年因急性冠脉综合征行冠脉介入治疗且符合入组标准的患者共343例，根据收集的基本资料进行China-PAR模型并结合基线资料，采用多因素Logistic回归模型分析急性冠脉综合征患者PCI术后再入院影响因素，使用Bootstrap法自抽样1000次进行内部验证，并绘制校准曲线。结果：年龄、性别、China-PAR、病变血管支数、糖尿病、高血压、心梗类型、Gensini评分分级、低密度脂蛋白是影响急性冠脉综合征PCI术后患者再入院的独立危险因素。将上述9个独立影响因素作为预测指标，构建高危的急性冠脉综合征患者PCI术后再入院模型，并进行内部验证，显示实际曲线与理想曲线的吻合度较好。结论：China-PAR模型是影响ACS患者PCI术后再入院的独立危险因素。

Abstract: Objectives: The China-PAR score has been recommended to assess the 10-year risk of CVD, but whether it can be used to predict adverse cardiovascular events in patients with acute coronary syndrome remains uncertain, and the current investigation of this study investigated the relationship between China-PAR score and readmission in patients with acute coronary syndrome after PCI. Methods: A total of 343 patients with acute coronary syndrome who underwent percutaneous coronary intervention (PCI) in our emergency department from 2018 to 2020 and met the criteria were retrospectively collected. China-PAR score was performed according to the collected basic data and combined with baseline data. Multivariate logistic regression model was used to analyze the influencing factors of readmission after PCI in patients with acute coronary syndrome. Bootstrap method was used to conduct internal validation by self-sampling for 1000 times, and the calibration curve was drawn. Results: Age, gender, China-PAR, number of diseased vessels, diabetes, hypertension, type of myocardial infarction, Gensini score grade, and low-density lipoprotein were independent risk factors for readmission in patients with acute coronary syndrome after PCI. The above 9 independent influencing factors were used as predictors to construct a readmission model for patients with acute coronary syndrome after PCI, and internal validation was performed, showing that the actual curve was in good agreement with the ideal curve. Conclusion: China-PAR model is an independent risk factor for readmission after PCI in ACS patients.