Abstract
We aim to integrate the parameters of two-dimensional (2D) echocardiography and identify the high-risk population for all-cause mortality in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). The study involved a retrospective cohort population with STEMI who were admitted to Yongchuan Hospital of Chongqing Medical University between January 2016 and January 2019. Baseline data were collected, including 2D echocardiography parameters and left ventricular ejection fraction (LVEF). The parameters of 2D echocardiography were subjected to cluster analysis. Logistic regression models were employed to assess univariate and multivariate adjusted odds ratios (ORs) of cluster information in relation to all-cause mortality. Four logistic regression models were generated, utilizing cluster information, clinical variables, clinical variables in conjunction with LVEF, and clinical variables in conjunction with LVEF and cluster information as predictive variables, respectively. The area under the curve (AUC) were utilized to evaluate the incremental risk stratification value of cluster information. The study included 633 participants with 28.8% female, a mean age of 65.68±11.98years. Over the course of a 3-year follow-up period, 108 (17.1%) patients experienced all-cause mortality. Utilizing cluster analysis of 2D echocardiography parameters, the patients were categorized into two distinct clusters, with statistically significant differences observed in most clinical variables, echocardiography, and survival outcomes between the clusters. Multivariate regression analysis revealed that cluster information was independently associated with the risk of all-cause mortality with adjusted OR 7.33 (95% confidence interval [CI] 3.99-14.06, P<0.001). The inclusion of LVEF enhanced the predictive capacity of the model utilized with clinical variables with AUC 0.848 (95% CI 0.809-0.888) versus AUC 0.872 (95% CI 0.836-0.908) (P<0.001), and the addition of cluster information further improved its predictive performance with AUC 0.906 (95% CI 0.878-0.934, P<0.001). This cluster analysis was translated into a free available online calculator (https://app-for-mortality-prediction-cluster.streamlit.app/). The 2D echocardiographic diagnostic information based on cluster analysis had good prognostic value for STEMI population, which was helpful for risk stratification and individualized intervention.
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
