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Research Paper|Volume 13, Issue 2|pp 2184—2197

Nomograms based on pre-operative parametric for prediction of short-term mortality in acute myocardial infarction patients treated invasively

Qingjie Wang1, Wei Qian2, Zhiqin Sun3, Wenwu Zhu4, Yu Liu1, Xin Chen1, Yuan Ji1, Ling Sun1
  • 1Department of Cardiology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
  • 2Department of Pediatrics, The Affiliated Wuxi Children’s Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
  • 3School of Clinical Medicine, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
  • 4Section of Pacing and Electrophysiology, Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
* Equal contribution
Received: April 6, 2020Accepted: October 20, 2020Published: December 11, 2020
https://doi.org/10.18632/aging.202230

Copyright: © 2021 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Objective Our aim was to develop and independently validate nomograms to predict short-term mortality in acute myocardial infarction (AMI) patients.

Results There were 1229 AMI patients enrolled in this study. In the training cohort (n=534), 69 deaths occurred during a median follow-up period of 375 days. The C-index for 1-year mortality in the training group and the validation cohort was 0.826 (95%CI: 0.780 - 0.872) and 0.775 (95%CI: 0.695 - 0.855), respectively. Integrated Discrimination Improvement (IDI) and net reclassification improvement (NRI) also showed a significant improvement in the accuracy of the new model compared with the Global Registry of Acute Coronary Events (GRACE) risk score. Furthermore, C-index of the prospective cohort (n=309) achieved 0.817 (95%CI: 0.754 - 0.880) for 30-day mortality and 0.790 (95%CI: 0.718 - 0.863) for 1-year mortality.

Conclusions Collectively, our simple-to-use nomogram effectively predicts short-term mortality in AMI patients.

Methods AMI patients who had undergone invasive intervention between January 2013 and Jan 2018 were enrolled. Cox regression analysis was used on the training cohort to develop nomograms for predicting 30-day and 1-year mortality. Model performance was then evaluated in the validation cohort and another independent prospective cohort.