Nomogram to predict the incidence of new-onset heart failure after acute coronary syndrome among women

Qiqi Yan; Lifang Ye; Qinggang Zhang; Jikai Song; Xin Zhang; Liuyang Wu; Lihong Wang

doi:10.3389/fcvm.2023.1131813

Nomogram to predict the incidence of new-onset heart failure after acute coronary syndrome among women

Front Cardiovasc Med. 2023 Mar 24:10:1131813. doi: 10.3389/fcvm.2023.1131813. eCollection 2023.

Authors

Qiqi Yan^{1

2}, Lifang Ye¹, Qinggang Zhang¹, Jikai Song³, Xin Zhang¹, Liuyang Wu^{1

2}, Lihong Wang¹

Affiliations

¹ Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China.
² The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China.
³ Zhejiang Provincial People's Hospital, Qingdao University, Hangzhou, China.

Abstract

Background: Although great progress has been made in caring for patients with acute coronary syndrome (ACS), the incidence of heart failure (HF) after discharge remains high after ACS.

Aims: We aimed to investigate the risk predictors for new-onset HF and build a simple nomogram to optimize the clinical management of female patients.

Methods: The clinical data of 319 female patients with ACS between January 1, 2021 and January 1, 2022, were obtained from the Zhejiang Provincial People's Hospital. Multivariate logistic regression analysis was carried out to build the prediction model among all participants and then verified by 10-fold cross-validation. The discrimination, calibration, and clinical usefulness of the prediction model were assessed using receiver operating characteristic curve, calibration curve, and decision curve analyses.

Results: This study analyzed 15 potential independent risk predictors of new-onset HF in 319 female patients with ACS. The incidence of HF onset was 23.2%. The following 5 independent risk predictors were filtered out as most relevant for predicting 12-month HF onset: left ventricular ejection fraction ≤ 60.5%, high-density lipoprotein ≤ 1.055 mmol/L, human epididymal protein 4 > 69.6 pmol/L, creatinine > 71.95 µmol/L, and diagnosis of myocardial infarction (MI).

Conclusion: Our nomogram, which used five easily obtained clinical variables, could be a useful tool to help identify female individuals with ACS who are at high risk of developing HF after discharge and facilitate communication between female patients and physicians.

Keywords: 10-fold cross-validation; acute coronary syndrome; heart failure; nomogram; women.

Grants and funding

This study was supported by the National Natural Science Foundation of China under Grant No. 81670447, the National Natural Science Foundation of Zhejiang Province under Grant No. LY15H020006, Zhejiang Province Key Subject of Medicine (Neurological Rehabilitation) and the Traditional Chinese Medicine Program of Zhejiang Province under Grant No. 2017ZZ001, and the Zhejiang Provincial Health Commission Project under Grant No. 2017KY559. LW was sponsored by the Zhejiang Provincial Program for the Cultivation of High-Level Innovative Health Talents.