Abstract:Objective To assess iCEB's predictive value for post-procedural MACE. Methods A retrospective study was conducted on 256 elderly patients with coronary heart disease who underwent drug coated balloon angioplasty at Huai'an First Hospital affiliated with Nanjing Medical University from April 2021 to February 2023. The patients were divided into MACE group(n=37) and non-MACE group(n=219) based on whether MACE occurred one year after surgery. Collect baseline data, preoperative, intraoperative, and postoperative data from patients. Multivariate Logistic regression analysis of the influencing factors of postoperative MACE, and ROC curve analysis of the predictive value of iCEB for postoperative MACE. Results The proportion of Lp(a), iCEB, and moderate to severe coronary artery calcification in the MACE group was higher than that in the non-MACE group(χ2/t/P=8.127/<0.001, 57.239/<0.001, 21.241/<0.001), while the LCX, collateral vessel proportion, QT, and QRS in the MACE group were lower than those in the non-MACE group(χ2/t/P=4.775/0.029, 4.700/0.030, 22.450/<0.001, 7.625/<0.001). there="" was="" no="" statistically="" significant="" difference="" in="" other="" clinical="" data="" between="" the="" two="" p="">0.05); The results of logistic regression analysis showed that LCX [OR=0.347, 95%CI 0.130-0.929] and collateral vessels [OR=0.433, 95%CI 0.200-0.937] were non risk factors for postoperative MACE, while moderate to severe coronary artery calcification [OR=2.979, 95%CI 1.464-6.061] and iCEB [OR=6.018, 95%CI 3.551-10.199] were risk factors for postoperative MACE(P<0.05); The ROC curve analysis results showed that the AUC of moderate to severe coronary artery calcification, iCEB, and their combined prediction of postoperative MACE were 0.745, 0.789, and 0.887, respectively. The combined detection efficiency of the two was better than that of each indicator detected separately(Z=3.200, 2.958, P<0.001 for all). Conclusion iCEB is a novel electrophysiological marker for post-DCB risk stratification in elderly CAD.
Key words:Coronary artery disease ; Drug-coated balloon ; Electrophysiological balance index ; Major adverse cardiovascular events ; Elderly
Funding: Jiangsu Health Commission Project(ZD2022041)