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已发表论文
预测经皮冠状动脉介入治疗后患者上消化道出血的列线图开发和外部验证：一项回顾性多中心队列研究
Authors Yang J, Liu Q, Wang S, Jv Y, Pan B, Feng S, Li J, Zhang L, Li X, Yu H
Received 5 November 2025
Accepted for publication 4 February 2026
Published 11 February 2026 Volume 2026:19 575300
DOI https://doi.org/10.2147/IJGM.S575300
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Redoy Ranjan
Jingyi Yang,1,* Qifeng Liu,2,* Songnan Wang,3 Yanling Jv,3 Bing Pan,1 Shengxiang Feng,1 Jiani Li,1 Lida Zhang,1 Xuqi Li,2 Hongwei Yu3
1Department of Cardiovascular Medicine, Graduate Training Base, Jinzhou Central Hospital, Jinzhou Medical University, Jinzhou, People’s Republic of China; 2Department of Cardiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, People’s Republic of China; 3Department of Cardiology, Jinzhou Central Hospital, Jinzhou, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Hongwei Yu, Department of Cardiology, Jinzhou Central Hospital, Jinzhou, Liaoning, 121000, People’s Republic of China, Email phyhw@163.com
Background: Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) increases the risk of upper gastrointestinal bleeding (UGIB) in patients with the acute coronary syndrome (ACS). As UGIB leads to a poor prognosis, it is essential to predict its occurrence early and effectively.
Objective: The study aimed to develop and validate a nomogram for predicting UGIB in patients with ACS undergoing DAPT after PCI.
Methods: This study was conducted on 1820 patients with ACS receiving DAPT after PCI in Jinzhou Central Hospital from January 2019 to September 2022. A logistic regression analysis was conducted to identify the risk factors of UGIB, which were utilized to develop a model for predicting the probability of UGIB in patients receiving DAPT. A validation cohort was used for verification. The discrimination, calibration, and clinical practicability of the nomogram were verified using receiver operating characteristic (ROC) curve analysis, Hosmer–Lemeshow (H–L) test, and decision curve analysis (DCA), respectively.
Results: Age, history of gastrointestinal ulcer/bleeding, heart failure, drinking status, and creatinine were independent risk factors for UGIB and included in our nomogram. The nomogram demonstrated good discriminative ability, with Area under the curve (AUC) values of 0.829, 0.848, and 0.838, respectively. The calibration curve and H–L test indicate that the model has good consistency (P = 0.948, P = 0.777, and P = 0.913, respectively). The nomograms can be clinically beneficial when the threshold probability is > 0.02 in both the training and validation cohorts.
Conclusion: Our prediction model can guides clinical physicians in risk stratification of undergoing DAPT patients after PCI by calculating the probability of UGIB. Our study may help clinicians in the early identification of patients at a high risk of UGIB and in providing a personalized treatment and management strategies to reduce the associated adverse outcomes.
Keywords: percutaneous coronary intervention, upper gastrointestinal bleeding, risk factor, prediction model, dual antiplatelet therapy
1Department of Cardiovascular Medicine, Graduate Training Base, Jinzhou Central Hospital, Jinzhou Medical University, Jinzhou, People’s Republic of China; 2Department of Cardiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, People’s Republic of China; 3Department of Cardiology, Jinzhou Central Hospital, Jinzhou, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Hongwei Yu, Department of Cardiology, Jinzhou Central Hospital, Jinzhou, Liaoning, 121000, People’s Republic of China, Email phyhw@163.com
Background: Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) increases the risk of upper gastrointestinal bleeding (UGIB) in patients with the acute coronary syndrome (ACS). As UGIB leads to a poor prognosis, it is essential to predict its occurrence early and effectively.
Objective: The study aimed to develop and validate a nomogram for predicting UGIB in patients with ACS undergoing DAPT after PCI.
Methods: This study was conducted on 1820 patients with ACS receiving DAPT after PCI in Jinzhou Central Hospital from January 2019 to September 2022. A logistic regression analysis was conducted to identify the risk factors of UGIB, which were utilized to develop a model for predicting the probability of UGIB in patients receiving DAPT. A validation cohort was used for verification. The discrimination, calibration, and clinical practicability of the nomogram were verified using receiver operating characteristic (ROC) curve analysis, Hosmer–Lemeshow (H–L) test, and decision curve analysis (DCA), respectively.
Results: Age, history of gastrointestinal ulcer/bleeding, heart failure, drinking status, and creatinine were independent risk factors for UGIB and included in our nomogram. The nomogram demonstrated good discriminative ability, with Area under the curve (AUC) values of 0.829, 0.848, and 0.838, respectively. The calibration curve and H–L test indicate that the model has good consistency (P = 0.948, P = 0.777, and P = 0.913, respectively). The nomograms can be clinically beneficial when the threshold probability is > 0.02 in both the training and validation cohorts.
Conclusion: Our prediction model can guides clinical physicians in risk stratification of undergoing DAPT patients after PCI by calculating the probability of UGIB. Our study may help clinicians in the early identification of patients at a high risk of UGIB and in providing a personalized treatment and management strategies to reduce the associated adverse outcomes.
Keywords: percutaneous coronary intervention, upper gastrointestinal bleeding, risk factor, prediction model, dual antiplatelet therapy