急性心肌梗死合并恶性室性心律失常患者预后的影响因素分析及列线图模型构建

doi:10.3969/j.issn.1006-6233.2025.08.014

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Abstract Objective: To analyze the influencing factors of prognosis in patients with acute myocardial infarction (AMI) complicated with malignant ventricular arrhythmia (MVA), and to construct a nomogram model and verify it. Methods: A total of 286 patients with AMI complicated with MVA in our hospital from June 2020 to July 2024 were chosen and split into modeling group and verification group. The patients were followed up for the recovery within 72 hours after admission and divided into poor prognosis group and good prognosis group. The nomogram model was developed using single-factor and binary logistic regression analysis, and its prediction accuracy was evaluated using the ROC, calibration, and DCA curves. Results: Among the 286 patients, 58 patients had a poor prognosis (20.28%). Compared with the good prognosis group, the levels of systolic blood pressure (SBP), diastolic blood pressure (DBP) and left ventricular ejection fraction (LVEF) in the poor prognosis group were decreased, the levels of serum magnesium, urea, galectin-3 (Gal-3), growth differentiation factor-15 (GDF-15) and Creatine kinase isoenzyme (CK-MB) were increased, and the proportion of QRS-T angle>90° was increased (all P<0.05). SBP, QRS-T angle, LVEF, serum magnesium, urea and CK-MB were independent influencing factors of poor prognosis in patients with AMI complicated with MVA. ROC curve analysis showed that the AUC of the nomogram model for predicting poor prognosis in the modeling group was 0.914 (95%CI: 0.877-0.952), and the AUC of the validation group was 0.949 (95%CI: 0.875-1.000). The calibration curve fits well with the ideal curve. The net income of each range of the threshold probability value of the DCA curve analysis is greater than 0. Conclusion: The nomogram model constructed in this study has good efficacy and can provide reference for medical staff to evaluate the prognosis of patients with AMI complicated with MVA.

Key words： Acute myocardial infarction Malignant ventricular arrhythmias Nomogram model

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.08.014 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I8/1315

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