Application of predicting risk of cardiovascular disease events equations on postoperative major adverse cardiac and cerebral events for patients undergoing thoracic surgery - Summary - MDSpire
To evaluate the association between PREVENT equations and postoperative cardiovascular events in thoracic surgical patients.
Approach:
Study Design: Retrospective cohort study of 1,073 patients undergoing thoracic surgery at Nanfang Hospital from January 2019 to October 2023.
Risk Assessment: Calculated sex-specific PREVENT risk scores for ASCVD, CHD, HF, and total CVD to assess 30-day postoperative MACCE.
Statistical Analysis: Used multivariate logistic regression and ROC curves to evaluate MACCE risk and discriminative ability.
Key Findings:
In females, a one SD increase in ASCVD score was associated with higher odds of postoperative angina (OR = 1.95, FDR corrected P = 0.0381).
CHD score was significantly associated with female angina (OR = 1.83, FDR corrected P = 0.0354) and AMI (OR = 1.46, FDR corrected P = 0.0386).
No PREVENT risk scores were significantly associated with MACCE in males (all FDR corrected P > 0.05).
The PREVENT equations showed light to moderate discrimination with AUCs ranging from 0.65 to 0.75 in female patients.
Interpretation:
The PREVENT equations demonstrated preliminary associations with 30-day postoperative MACCE in non-cardiac thoracic surgical female patients, but not in male patients.
Limitations:
Retrospective design may introduce bias.
Findings may not be generalizable to all thoracic surgical populations.
Conclusion:
The PREVENT equations may be useful for assessing cardiovascular risk in female patients undergoing thoracic surgery.
Advanced heart failure does not always present as a single defining event. Referring physicians may instead notice a pattern of worsening symptoms, recurrent hospitalizations or increasing difficulty maintaining a patient’s clinical stability.
