冠心病合并2型糖尿病患者冠状动脉正性重构的影响因素及临床预测模型构建OACSTPCD

Objective To explore the influencing factors of coronary artery positive remodeling in patients with coronary heart disease(CHD)and type 2 diabetes,and to construct related clinical prediction models to identify high-risk patients early and guide clinical treatment.Methods One hundred and four patients with coronary heart disease and type 2 diabetes diagnosed in the Cardiovascular Center of Beijing Tongren Hospital affiliated to Capital Medical University from January 2016 to June 2023 were selected.The target lesions were measured by intracoronary ultrasound(IVUS),and the re-construction index(RI)was calculated.According to RI,patients were divided into positive reconstruction group and non positive reconstruction group.Clinical data of patients were collected,and the data of the two groups were statistically ana-lyzed and a clinical prediction model was constructed.Results Low blood calcium[OR(95%CI)=1.544(1.263-1.927),P<0.001],concurrent acute coronary syndrome(ACS)[OR(95%CI)=1.198(1.024-1.401),P=0.024],high glycated hemoglo-bin(HbA1c)[OR(95%CI)=1.498(1.104-2.032),P=0.010]and high and low density lipoprotein cholesterol(LDL-C)[OR(95%CI)=1.275(1.139-1.428),P<0.001]are independent risk factors for positive remodeling of coronary artery in this population.Based on the above risk factors,a nomograph model of positive remodeling of coronary artery in patients with coronary heart disease and type 2 diabetes was constructed.The predicted incidence rate was basically consistent with the actual incidence rate.The area under the internal validation curve(AUC)of the model was 0.937,And it has good clinical applicability.Conclusion The nomogram model based on the risk factors of patients with coronary heart disease and type 2 diabetes has a good predictive effect on the occurrence of positive coronary remodeling.