中国急性心肌梗死患者PCI术后心力衰竭风险预测模型的系统评价和Meta分析

BackgroundAcute myocardial infarctionAMI is one of the leading causes of death worldwideand percutaneous coronary interventionPCI is the preferred clinical treatment option for most AMI patients. Howeverpatients still face a high risk of heart failureHF post-PCIwith poor prognosisseverely impacting their quality of life and long-term survival rates. ObjectiveThe risk prediction model of HF after PCI in patients with AMI was evaluated with the aim of providing reference for the developmentoptimisation and application of the model. MethodsA computerized systematic search was conducted across PubMedWeb of ScienceEmbaseCNKIVIP and Wanfang Data for relevant literature on HF risk prediction models in AMI patients post-PCIwith the search period spanning from database inception to November 122024. Two researchers independently screened the literatureextracted dataand assessed the quality of included studies using the PROBAST tool. Meta-analysis of HF risk predictors in AMI patients post-PCI was performed using RevMan 5.4 software. ResultsA total of 18 papers were includedwith a sample number of 6 375 casesand the incidence rate of HF was 13%. The incidence of HF ranged from 13.7% to 34.8%with a total of 21 HF risk prediction models for post-PCI in patients with AMIand the area under the curve of the working characteristicAUC of the subjects ranged from 0.657% to 0.966%with 17 prediction models having good predictive performanceAUC>0.7and the overall bias of the literature was high risk of bias and good applicability. Statistical analysis of model predictive performance AUC was performed using MedCalc softwareand the combined AUC was 0.85295%CI=0.815-0.890. Meta-analysis results indicated that ageGensini scorearrhythmiaserum creatinineScrventricular wall motion amplitudehypertensiondiabetes mellitusleft ventricular ejection fraction LVEFhigh-sensitivity C-reactive proteinhsCRPN-terminal pro-brain natriuretic peptideNT-proBNPbrain natriuretic peptideBNPnumber of lesion vesselscardiac structural changesand anterior wall myocardial infarction were predictors of HF in AMI patients post-PCIP<0.05. ConclusionCurrentlythe risk prediction risk prediction model for post-PCI HF risk prediction in AMI patients is still in the exploratory stagewith good model differentiation but high overall risk of biasand the study design should be optimised and the reporting process should be improved in the future in order to ensure that a predictive model with strong clinical utility is developed.