Long-term prognostic value of QRS score in patients with successfully recanalized coronary chronic total occlusion and construction of a predictive nomogram model

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• 作者：Hao Xie^a ; Li-ming Chen^a ; Hai-hui Sun^b ; Lin Li^c ; Hang Liu^a ; Wen-jia Li^a ; Jian-bang Jiang^a ; Lian-qun Cui^a ; ^{lianqun_cui@163.com}
• 关键词：Chronic total occlusion ; QRS score ; Prognostic ; Nomogram
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：15 January 2017
• 年：2017
• 卷：227
• 期：Complete
• 页码：698-703
• 全文大小：380 K
• 卷排序：227

文摘

Few studies have evaluated the prognostic value of QRS score in patients with coronary chronic total occlusion (CTO) after successful recanalization.MethodsA total of 474 patients with successfully recanalized coronary CTO were finally included in our study and were followed up for 34.0 ± 5.3 months. They were divided into 3 groups: QRS score ≥ 8, QRS score 4–7 and QRS score 0–3. The primary outcome was composite endpoint of major adverse cardiac and cerebral events (MACCEs). A predictive nomogram was established to predict prognosis for MACCEs, and the predictive accuracy of the nomogram was determined by concordance index.ResultsWe found that QRS score correlated moderately with wall motion score index (WMSI) (r = 0.551, p < 0.001), left ventricular ejection fraction (LVEF) (r = − 0.339, p < 0.001) and coronary collateral circulation (CCC) (r = − 0.569, p < 0.001). During follow-up, patients with higher QRS score were observed to undergo poor prognosis. After multivariable adjustment, QRS score was still a significant independent predictor for MACCEs [(hazard ratio 1.28, 95% CI 1.18–1.39, p < 0.001) in model 1,(hazard ratio 1.30, 95% CI 1.21–1.41, p < 0.001) in mode2] and mortality[(hazard ratio 1.33, 95% CI 1.14–1.57, p < 0.001) in model 1, (hazard ratio 1.49 , 95% CI 1.24–1.79, p < 0.001) in model 2]. Moreover, the nomogram could more accurately predict 3-year MACCEs (c-index: 0.84).ConclusionQRS score is a strong independent predictor of long-term prognosis in patients with coronary CTO successfully recancalized. The proposed nomograms can be used for the prediction of MACCE in this population.