关键词: 冠心病, 老年, 主要心血管不良事件, 网膜素-1, 趋化素

Abstract:

Objective To explore the association between serum omentin-1 and chemerin levels and the risk of major adverse cardiovascular events （MACE） in elderly patients with coronary heart disease （CHD）. Methods A total of 313 elderly patients with coronary heart disease （CHD） admitted to the Department of Cardiology， Tangshan Workers' Hospital between January 2023 and January 2025 were recruited as study subjects. After excluding 13 patients who were lost to follow-up， 300 patients were ultimately included in the study. The patients were then classified into the major adverse cardiovascular events （MACE） group and the non-MACE group according to the occurrence of MACE. Baseline data， clinical data， and serum levels of omentin-1 and chemerin in the two groups were statistically analyzed. Spearman correlation analysis was employed to investigate the association between serum omentin-1 and chemerin levels and the risk of MACE in elderly CHD patients. LASSO regression and multivariate logistic regression were utilized to identify the risk factors for MACE in elderly CHD patients. Based on the results of multivariate logistic regression analysis， a nomogram prediction model was developed and internally validated using the calibration curve and receiver operating characteristic （ROC） curve. The clinical utility of the model was assessed through decision curve analysis. Results During the follow-up period， 97 patients （32.33%） experienced Major Adverse Cardiovascular Events （MACE） （MACE group）， whereas the remaining 203 patients （67.67%） did not （non-MACE group）. The MACE group exhibited lower serum omentin-1 levels and higher chemerin levels compared to the non-MACE group （P < 0.05）. The results of Spearman correlation analysis indicated that the occurrence of MACE was negatively correlated with the serum omentin-1 level （r = -0.637， P < 0.001） and positively correlated with the serum chemerin level （r = 0.552， P < 0.001） among elderly patients with Coronary Heart Disease （CHD）. Multivariate logistic regression analysis demonstrated that omentin-1 （95%CI： 0.992 ~ 0.997）， chemerin （95%CI： 1.012 ~ 1.058）， Gensini score （95%CI： 1.012 ~ 1.165）， C-reactive protein （CRP） （95%CI： 1.711 ~ 3.627）， and Left Ventricular Ejection Fraction （LVEF） （95%CI： 0.756 ~ 0.895） were influencing factors for MACE in elderly CHD patients （P < 0.05）. ROC curve analysis revealed that the areas under the curve （AUCs） of omentin - 1 and chemerin for predicting MACE in elderly CHD patients were 0.893 （95%CI： 0.852 ~ 0.926） and 0.841 （95%CI： 0.794 ~ 0.880）， respectively. The AUC of the nomogram model constructed based on the results of multivariate logistic regression analysis for predicting MACE in elderly CHD patients was 0.979 （95%CI： 0.956 ~ 0.992）. The calibration curve showed a good agreement between the predicted curve and the ideal curve， suggesting good model calibration. Decision curve analysis indicated that when the risk threshold probability ranged from 0.01 to 0.99， the model could yield better clinical benefits. Conclusions Omentin-1 and chemerin are intricately associated with the occurrence of Major Adverse Cardiovascular Events （MACE） in elderly patients with Coronary Heart Disease （CHD） and possess excellent predictive value. The nomogram model constructed based on indicators such as omentin-1 and chemerin exhibits superior predictive performance and can offer a reference for the clinical assessment of the risk of MACE in elderly patients with CHD.

Key words: coronary heart disease, elderly, major adverse cardiovascular events, omentin-1, chemerin