IMR Press / RCM / Volume 24 / Issue 12 / DOI: 10.31083/j.rcm2412344
Open Access Original Research
A Nomogram to Predict the Risk for MACCE within 1 Year after Discharge of Patients with NVAF and HFpEF: A Multicenter Retrospective Study
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1 Department of Cardiology, Zhongda Hospital, Southeast University, 210009 Nanjing, Jiangsu, China
2 Department of Geriatrics, Taizhou People’s Hospital, 225300 Taizhou, Jiangsu, China
*Correspondence: dingjiandong@163.com (Jiandong Ding)
Rev. Cardiovasc. Med. 2023, 24(12), 344; https://doi.org/10.31083/j.rcm2412344
Submitted: 7 June 2023 | Revised: 4 July 2023 | Accepted: 13 July 2023 | Published: 12 December 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: To develop and validate a nomogram prediction model for assessing the risk of major adverse cardiovascular and cerebrovascular events (MACCE) in patients with nonvalvular atrial fibrillation (NVAF) and heart failure with preserved ejection fraction (HFpEF) within one year of discharge. Methods: We enrolled 828 patients with NVAF and HFpEF from May 2017 to March 2022 in Zhongda Hospital as the training cohort, and 564 patients with NVAF and HFpEF in Taizhou People’s Hospital between August 2018 and March 2022 as the validation cohort. A total of 35 clinical features, including baseline characteristics, past medical records, and detection index, were used to create a prediction model for MACCE risk. The optimized model was verified in the validation cohort. Calibration plots, the Hosmer-Lemeshow test, and decision curve analyses (DCA) were utilized to assess the accuracy and clinical efficacy of the nomogram. Results: MACCE occurred in 23.1% of all patients within one year of discharge. The nomogram identified several independent risk factors for MACCE, including atrial fibrillation duration 6 years, poor medication compliance, serum creatinine level, hyperthyroidism, serum N-terminal pro-brain natriuretic peptide level, and circumferential end-diastolic stress. The DCA demonstrated the excellent efficacy of the prediction model for the MACCE end-point, with a wide range of high-risk threshold probabilities in both cohorts. The Hosmer-Lemeshow test confirmed that momogram predictions fit for both the training (p = 0.573) and validation (p = 0.628) cohorts. Conclusions: This nomogram prediction model may offer a quantitative tool for estimating the risk of MACCE in patients with NVAF and HFpEF within one year of discharge.

Keywords
major adverse cardiovascular and cerebrovascular events
nonvalvular atrial fibrillation
heart failure with preserved ejection fraction
nomogram
prediction model
Funding
QDJJ202114/Taizhou People’s Hospital Research Start-up Fund Project
Figures
Fig. 1.
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