药物涂层球囊治疗急性心肌梗死患者1年MACE事件的危险因素分析

Risk Factor Analysis of 1-Year MACE Events in Patients with Acute Myocardial Infarction Treated with Drug-Coated Balloon

摘要: 目的：分析急性心肌梗死(AMI)患者药物涂层球囊(DCB)治疗术后1年发生MACE事件的危险因素。方法：连续性纳入2021年1月~2023年12月于青岛市海慈医院心内科行DCB治疗的AMI患者192例。根据患者DCB治疗后1年MACE事件发生情况，将其分为非MACE组(156例)和MACE组(36例)。收集患者一般资料、术中术后资料、治疗情况、1年随访情况等资料，采用Cox回归分析分析AMI患者DCB治疗后发生MACE事件的影响因素，绘制受试者工作特征(ROC)曲线，评估影响因素的预测效能。结果：多因素Cox回归分析显示，STEMI (HR = 2.187, 95%CI = 1.016~4.708, P < 0.05)，靶血管为LCX (HR = 0.021, 95%CI = 0.006~0.070, P < 0.05)、RCA (HR = 0.028, 95%CI = 0.010~0.083, P < 0.05)是AMI患者DCB治疗后1年MACE事件的独立预测因素。ROC曲线分析显示，STEMI、靶血管为RCA、LCX联合预测术后1年MACE事件发生的效能较高(AUC = 0.827, 95%CI = 0.720~0.934, P < 0.05)。结论：相较于非ST段抬高型心肌梗死，ST段抬高型心肌梗死对AMI患者行药物涂层球囊治疗后1年MACE事件的发生具有一定的预测价值；相较于靶血管为LAD，靶血管为RCA及LCX对AMI患者行药物涂层球囊治疗后1年MACE事件的发生具有一定的预测价值，并且联合预测MACE事件发生的效能较高。

Abstract: Objective: To analyze the risk factors for Major Adverse Cardiovascular Event (MACE) in patients with Acute Myocardial Infarction (AMI) who underwent Drug-Coated Balloon (DCB) treatment within 1 year. Methods: 192 patients with AMI who underwent DCB treatment in the Cardiology Department of Qingdao Haici Hospital from January 2021 to December 2023 were continuously enrolled. According to 1-year MACE event incidence after DCB treatment, they were divided into the non-MACE group (156 cases) and the MACE group (36 cases). The patients’ general information, intraoperative and postoperative information, treatment situation, and 1-year follow-up information were collected, and Cox regression analysis was used to analyze the influencing factors of MACE events in patients with AMI after DCB treatment, and the Receiver Operating Characteristic (ROC) curve was drawn to evaluate the predictive ability of the influencing factors. Results: The multivariate Cox regression analysis showed that STEMI (HR = 2.187, 95% CI=1.016~4.708, P < 0.05) and target vessel as LCX (HR = 0.021, 95% CI = 0.006~0.070, P < 0.05) and RCA (HR = 0.028, 95% CI = 0.010~0.083, P < 0.05) were independent predictors of MACE events in patients with AMI after DCB treatment within 1 year. The ROC curve analysis showed that the predictive ability of combined STEMI and target vessel as RCA and LCX in predicting MACE events within 1 year after DCB treatment was high (AUC = 0.827,95%CI = 0.720~0.934, P < 0.05). Conclusion: Compared with non-ST-segment elevation myocardial infarction, ST-segment elevation myocardial infarction has a certain predictive value for the occurrence of MACE events in patients with AMI treated with DCB within 1 year; compared with target vessel for LAD, target vessels for RCA and LCX have a certain predictive value for the occurrence of MACE events in patients with AMI treated with DCB within 1 year and the combined prediction of MACE events has a higher predictive ability.