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Establishment of a Nomogram for Predicting the Suboptimal Angiographic Outcomes of Coronary De Novo Lesions Treated with Drug-Coated Balloons

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Abstract

Introduction

Factors affecting the angiographic outcomes of coronary de novo lesions treated with drug-coated balloons (DCBs) have not been well illustrated. The aim of the study is to establish a nomogram for predicting the risk of suboptimal diameter stenosis (DS) at angiographic follow-up.

Methods

A retrospective analysis was performed on a cohort of patients who underwent DCB intervention for coronary de novo lesions with angiographic follow-up data. Multivariable logistic regression analysis was applied to determine the independent predictors of DS ≥ 30% at follow-up, and then a nomogram model was established and validated.

Results

A total of 196 patients (313 lesions) were divided into the suboptimal (DS ≥ 30%) and optimal (DS < 30%) DS groups according to quantitative coronary angiography (QCA) measurements of the target lesions at follow-up. Seven independent factors including calcified lesions, true bifurcation lesions, immediate lumen gain rate (iLG%) < 20%, immediate diameter stenosis (iDS) ≥ 30%, DCB diameter/reference vessel diameter ratio (DCB/RVD) < 1.0, DCB length and mild dissection were identified. The area under the curve (AUC) (95% CI) of the receiver-operating characteristic (ROC) curve of the nomogram was 0.738 (0.683, 0.794). After the internal validation, the AUC (95% CI) was 0.740 (0.685, 0.795). The Hosmer-Lemeshow goodness of fit (GOF) test (χ2 = 6.57, P = 0.766) and the calibration curve suggested a good predictive consistency of the nomogram.

Conclusions

The well-calibrated nomogram could efficiently predict the suboptimal angiographic outcomes at follow-up. This model may be helpful to optimize lesion preparation to achieve optimal outcomes.

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Acknowledgements

We thank the participants of the study.

Funding

This study was funded by the Research Fund for clinical and translational medicine, Chinese Academy of Medical Sciences (grant number 2020-I2M-C&T-B-092), the Scientific Research Project of Central Health Committee (grant number 2020YB08) and the National High Level Hospital Clinical Research Funding (grant number BJ-2022–124). The journal’s Rapid Service Fee was funded by the authors.

Medical Writing, Editorial and Other Assistance

Medical writing/editorial support was provided by Cassie J., the Senior Editor of American Journal Experts, and funded by the authors.

Author Contributions

Conception and design: XY, FJ; Acquisition of data: XY, WZ, XW, CY, PL; Analysis and interpretation of the data: XY, YW, NJ, YZ; Drafting and critical revision of the article for important intellectual content: FJ, FX, XY.

Disclosures

Xue Yu, Yijia Wang, Wenduo Zhang, Xinyue Wang, Na Jia, Yanan Zhang, Chenguang Yang, Peng Li, Feng Xu and Fusui Ji have nothing to disclose.

Compliance with Ethics Guidelines

This study was conducted in accordance with the ethical principles of the Declaration of Helsinki, Good Clinical Practice, the International Committee on Harmonisation guidelines and applicable laws and regulations. The protocol was approved by the ethics committee of Beijing Hospital (ID: 2016BJYYEC-067–01) and all subjects provided written informed consent.

Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Author notes

  1. Xue Yu and Yijia Wang contributed equally to this article.

Authors and Affiliations

  1. Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, People’s Republic of China

    Xue Yu, Wenduo Zhang, Xinyue Wang, Na Jia, Chenguang Yang, Peng Li, Feng Xu & Fusui Ji

  2. Department of Cardiology, Beijing Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of China

    Yijia Wang

  3. Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China

    Yanan Zhang

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  1. Xue Yu
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Correspondence to Fusui Ji.

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Yu, X., Wang, Y., Zhang, W. et al. Establishment of a Nomogram for Predicting the Suboptimal Angiographic Outcomes of Coronary De Novo Lesions Treated with Drug-Coated Balloons. Adv Ther 40, 975–989 (2023). https://doi.org/10.1007/s12325-022-02400-1

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