转化医学杂志2026，Vol.15Issue(3)：367-373,7.DOI:10.3639/j.issn.2095-3097.2026.03.002
冠状动脉粥样硬化性心脏病冠状动脉多支病变的风险评分模型构建与验证
Development and Validation of a Risk Score Model for Multivessel Coronary Artery Disease in Patients with Coronary Heart Disease
摘要
Abstract
Objective To identify independent risk factors for multivessel coronary artery disease(MVD)and to develop a nomogram for predicting MVD risk.Methods A total of 311 patients diagnosed with coronary artery disease(CAD)who underwent coronary angiography during hospitalization in the Emergency Department of Xuanwu Hospital,Capital Medical University,from September 2023 to December 2024 were retrospectively enrolled.They were divided into the single-vessel disease group(126 cases)and the multi-vessel disease group(185 cases)according to the number of diseased coronary artery branches.Baseline data were compared between the two groups.Univariate and multivariate logistic regression analyses were performed to identify the influencing factors for coronary multi-vessel disease in CAD patients.All patients were assigned to the training set(186 cases)and the validation set(125 cases)at a ratio of 3:2.A nomogram prediction model was established based on the training set,and the validation set was used for internal validation.The discriminative ability,calibration performance,and clinical application value of the model were comprehensively evaluated by means of receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis.Results The multi-vessel disease group had higher levels of alcohol consumption,diabetes mellitus,white blood cell count,neutrophil count,triglyceride-glucose index,systemic immune-inflammation index,and platelet-to-lymphocyte ratio,but lower prevalence of hypertension,lower age,and lower lymphocyte-albumin-neutrophil ratio compared with the single-vessel disease group(P<0.05).Multivariate logistic regression analysis showed that alcohol consumption,diabetes mellitus,triglyceride-glucose index,and platelet-to-lymphocyte ratio were independent risk factors for coronary multi-vessel disease in patients with coronary artery disease(alcohol consumption:OR=2.231,95%CI:1.992-5.031,P=0.042;diabetes mellitus:OR=13.607,95%CI:6.961-26.596,P<0.001;triglyceride-glucose index:OR=1.113,95%CI:1.053-1.177,P<0.001;platelet-to-lymphocyte ratio:OR=1.013,95%CI:1.006-1.021,P<0.001).ROC curve analysis indicated that the area under the curve was 0.860(95%CI:0.807-0.914)in the training set and 0.888(95%CI:0.832-0.945)in the validation set.The Hosmer-Lemeshow goodness-of-fit test showed good calibration(P=0.798 for the training set,P=0.966 for the validation set).Decision curve analysis demonstrated that the nomogram yielded a higher net benefit for predicting the risk of multi-vessel disease when the threshold probability ranged from 0 to 0.9.Conclusion Alcohol consumption,diabetes mellitus,triglyceride-glucose index,and platelet-to-lymphocyte ratio were identified as independent risk factors for multi-vessel coronary artery disease in patients with coronary heart disease.The nomogram prediction model constructed based on these factors exhibited good discrimination and calibration,which can assist in the early clinical identification of high-risk populations.关键词
冠状动脉多支病变/列线图/预测模型Key words
coronary artery multivessel disease/nomogram/predictive model引用本文复制引用
王雪莲,刘宇琦,高文慧,张秀梅,刘志..冠状动脉粥样硬化性心脏病冠状动脉多支病变的风险评分模型构建与验证[J].转化医学杂志,2026,15(3):367-373,7.基金项目
国家自然科学基金面上项目(62172288) （62172288）
