A Nomogram Predicting 1-Year Co-Progression of Carotid and Coronary Plaque in Patients After Coronary Stenting

Backgroud : The concordance of carotid and coronary plaque progression warrants investigation. Objectives : We aimed to analyze the correlation between them and to explore a nomogram for predicting multisite plaque co-progression in patients implanted with coronary drug-eluting stents (DES). Methods : 909 patients were enrolled and randomized in a 7:3 ratio to the training and validation groups. LASSO (Least absolute shrinkage and selection operator) and logistic regressions determined risk factors. The nomogram visualized the prediction model. Concordance index (C-index), receiver operating characteristic (ROC) curve, and calibration curve validated the discrimination and calibration of the model. Decision curve analysis (DCA) and clinical impact curve assessed the clinical utility value of the nomogram. Results : In our study, there was no statistical correlation between the concordance assessed by McNemar's test. Five variables were selected to establish the nomogram which displayed a robust discriminative ability with C-index of 0.837 [95% confidence interval (CI)=0.779-0.895) and 0.802 (95% CI=0.762-0.842), and area under the receiver operating characteristic curve (AUC) of 0.823 (95% CI=0.769-0.887) and 0.803 (95% CI=0.762-0.842) for the training and validation cohorts, respectively. The calibration results indicated favorable agreement between the predicted and actual probability. Furthermore, DCA and clinical impact curve showed the benefit of the nomogram in the clinical decision. Conclusion : The progression of carotid and coronary plaque was not highly concordant in patients with coronary DES at one-year follow up. The atherosclerotic plaque risk factor (ASPRF) nomogram showed effectively predictive value and clinical utility for the co-progression of carotid and coronary plaque after coronary DES implantation.