A nomogram to predict major adverse cardiovascular events of patients with acute chest pain, Non-ST-segment deviation, and normal troponin concentrations

• Published in: European review for medical and pharmacological sciences Vol. 24; no. 19; p. 10096
• Main Authors: Cao, Z-N, Wang, K, Zuo, G-X, Zhang, M-H, Jia, X-G, Li, Y, Wang, C-C, Zhang, X-C, Li, X-B, Du, X-P
• Format: Journal Article
• Language: English
• Published: Italy 01.10.2020
• Subjects: Aged; C-Reactive Protein - analysis; Cardiovascular Diseases - blood; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - physiopathology; Chest Pain - blood; Chest Pain - diagnosis; Chest Pain - physiopathology; Echocardiography; Electrocardiography; Female; Humans; Male; Middle Aged; Nomograms; Prospective Studies; Risk Factors; Troponin T - blood
• ISSN: 2284-0729
• DOI: 10.26355/eurrev_202010_23229

To explore the potential indicators including patients' characteristics, electrocardiogram (ECG), echocardiography, and serological assay in predicting the major adverse cardiovascular events (MACE) within 1 year for patients with low-risk chest pain with a nomogram. The detected indicators of patients with low-risk chest pain were obtained as the alternative predictors for MACE. After the 1-year follow-up, patients with MACE were enrolled in the MACE group while the remained patients were in the non-MACE group. A nomogram was constructed based on the multivariable Cox regression to link the independent predictors and the MACE within 1 year for patients with low-risk chest pain. The incidence of MACE within 1 year was 6.94% according to the follow-up result. Multivariate analysis revealed that risk factors of CAD, P-terminal force in lead V1 (PTFV1), C-reactive protein (CRP), and transmitral inflow early diastolic peak velocity (E wave) /peak early diastolic velocity (Em) (E/Em) were the independent predictors for the MACE. A nomogram incorporating these independent predictors with a good discrimination (0.79 in C-index) and calibration was constructed to predict the incidence of MACE within 1 year. It could be used to help select the patients with a high risk of MACE and develop preventive treatment strategies. Risk factors of CAD, PTFV1, CRP, and E/Em were the independent predictors for the MACE within 1 year in patients with low-risk chest pain. The present nomogram provides a user friendly tool in the prediction of MACE for these patients.