Nomogram predicting long-term cardiac mortality in diabetic patients with coronary artery disease

Abstract

Abstract Purpose This study aims at developing a prognostic nomogram base on traditional clinical parameters to predict cardiac mortality of patients with type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD). Methods The data was collected from patients diagnosed T2DM and CAD in the first affiliated hospital of Zhengzhou University from January 2012 to December 2016 with clinical and follow-up information intact. A total of 448 patients were involved in the study and randomly divided into training and testing cohorts using a 7:3 ratio. The risk factors involved in the model were selected by Cox regression analysis in the training cohort and validated in the testing cohort. Results The multivariate Cox regression analysis revealed that the Gensini score (HR 1.01, 95%CI 1-1.02, p = 0.003), left ventricular ejection fraction (HR 0.95, 95%CI 0.91–0.98, p = 0.001), age (HR 1.05, 95%CI 1.01–1.1, p = 0.010) and estimated glomerular filtration rate (HR 0.98, 95%CI 0.96-1, p = 0.038) were independent risk factors for cardiac death. The nomogram was established with a AUC of 1-, 3- and 5-year at 0.90, 0.91 and 0.86 in the training cohort, 0.97, 0.97 and 0.87 in the validation cohort. The KM curve revealed that rate of cumulative cardiac death was significantly higher in the high-risk group stratified with Youden’s Index of the predicted risk (Log Rank p < 0.001). Conclusion The nomogram containing readily available parameters from clinic performed well for cardiac mortality in patients with T2DM and CAD. Trial registration number and date of registration: 2022-KY-1053 (August 16, 2022)