A Nomogram Based on the Castelli Risk Index for Predicting Prognosis in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Cohort Study

BACKGROUND AND AIMS: Composite lipid indices are closely related to the risk and poor prognosis of diseases. However, there are no studies on the prognostic value of Castelli's risk indices-I and II (CRI-I, CRI-II) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Therefore, the aim of this study was to investigate the association of CRI-I and CRI-II with the prognosis of patients with ACS undergoing PCI. PATIENTS AND METHODS: A total of 1475 patients with ACS undergoing PCI were consecutively enrolled in this prospective cohort study from January 2016 to December 2018. The CRI-I and CRI-II were measured. The endpoints were MACEs, including all-cause mortality, requirement of rehospitalization for severe heart failure, recurrence of myocardial infarction, in-stent restenosis, and reaccept PCI. Follow-up data were collected via clinical visits or telephone calls at 1, 3, 6, and 12 months and annually thereafter. RESULT: Multivariable Cox regression analysis revealed that the risk of MACEs increased gradually with increasing CRI-I and CRI-II. The cumulative survival rate in the CRI-I ≥ 3.350 and CRI-II ≥ 1.697 groups was significantly lower than that in the CRI-I < 3.350 and CRI-II < 1.697 groups, respectively (log-rank tests: all p < 0.001). The nomogram demonstrated good predictive performance for the 1-, 2-, and 3-year survival probability. CONCLUSIONS: CRI-I ≥ 3.350 and CRI-II ≥ 1.697 could serve as independent predictors of MACEs in patients with ACS undergoing PCI.