Value of electrocardiographic parameters combined with serum NT-proBNP and 25-OH-VitD3 levels in predicting major adverse cardiovascular events in patients with chronic heart failure

doi:10.3969/j.issn.1004-583X.2026.07.002

Abstract

Abstract:

Objective To investigate the value of electrocardiographic parameters combined with serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and 25-hydroxyvitamin D3 (25-OH-VitD3) levels in predicting major adverse cardiovascular events (MACE) in patients with chronic heart failure (CHF). Methods This retrospective cohort study included the medical records of 272 patients with CHF admitted to the Department of Cardiology, Xinxiang First People’s Hospital, from November 2022 to November 2024. According to whether MACE occurred within 12 months of follow-up, patients were divided into a MACE group (n=76) and a non-MACE group (n=196). Baseline characteristics, electrocardiographic parameters on the day of admission (T wave peak-to-end interval [Tp-Te], corrected QT dispersion [QTcd], and QRS duration [QRSd]), and serum NT-proBNP and 25-OH-VitD3 levels were compared between the two groups. A multivariable logistic regression model was constructed to analyze the predictive value of these indicators for MACE occurrence. Results Compared with the non-MACE group, the MACE group had higher age, a higher proportion of patients with cardiac function grade Ⅲ-Ⅳ, and higher Tp-Te, QTcd, QRSd, and serum NT-proBNP levels (P<0.05), as well as lower 25-OH-VitD3 levels (P<0.05). Multivariable logistic regression analysis showed that higher Tp-Te, higher QTcd, higher QRSd, higher NT-proBNP levels, and lower 25-OH-VitD3 levels were independent risk factors for MACE within 12 months in patients with CHF (P<0.05). The combined prediction model using Tp-Te, QTcd, QRSd, serum NT-proBNP, and 25-OH-VitD3 achieved the highest predictive performance for MACE, with a sensitivity of 88.16% and a specificity of 73.98%. Conclusion Electrocardiographic parameters Tp-Te, QTcd, and QRSd, along with serum NT-proBNP and 25-OH-VitD3 levels, can serve as effective indicators for predicting MACE in patients with CHF. The logistic regression model constructed from these five indicators provides superior combined predictive performance.

Key words: heart failure, electrocardiogram parameters, major cardiovascular adverse events, N-terminal pro-brain natriuretic peptide, 25-hydroxyvitamin D3

CLC Number:

R541.62

Li Huidan, Sui Guoxin, Zhao Juan, Yang Tao. Value of electrocardiographic parameters combined with serum NT-proBNP and 25-OH-VitD3 levels in predicting major adverse cardiovascular events in patients with chronic heart failure[J]. Clinical Focus, 2026, 41(7): 590-595.

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References 19

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资料	MACE组(n=76)	无MACE组(n=196)	χ²/t值	P值
性别[例(%)]
男女	44(57.89) 32(42.11)	118(60.20) 78(39.80)	0.121	0.728
年龄(岁)	67.82±4.34	65.12±3.67	5.166	<0.01
心功能分级[例(%)]
Ⅱ级 Ⅲ~Ⅳ级	19(25.00) 57(75.00)	89(45.41) 107(54.59)	9.528	0.002
合并症[例(%)]
高血压	52(68.42)	142(72.45)	1.032	0.310
糖尿病	24(31.58)	46(23.47)	1.884	0.170
冠心病	18(23.68)	53(27.04)	0.320	0.572
吸烟史	35(46.05)	72(36.73)	1.993	0.158
饮酒史	21(27.63)	63(32.14)	0.522	0.470
合并用药	72(94.74)	185(94.39)	0.013	0.910
总胆固醇(mmol/L)	5.82±0.65	5.71±0.58	1.356	0.176
甘油三酯(mmol/L)	2.05±0.42	1.97±0.39	1.512	0.132
低密度脂蛋白胆固醇(mmol/L)	3.25±0.71	3.12±0.68	1.397	0.163
高密度脂蛋白胆固醇(mmol/L)	1.18±0.24	1.22±0.26	1.163	0.246
空腹血糖(mmol/L)	7.96±1.25	7.78±1.19	1.104	0.271
LVEF(%)	35.26±4.18	42.58±5.32	10.771	<0.01
LVEDD(mm)	58.35±5.26	57.39±4.97	1.406	0.161

资料	MACE组(n=76)	无MACE组(n=196)	χ²/t值	P值
性别[例(%)]
男女	44(57.89) 32(42.11)	118(60.20) 78(39.80)	0.121	0.728
年龄(岁)	67.82±4.34	65.12±3.67	5.166	<0.01
心功能分级[例(%)]
Ⅱ级 Ⅲ~Ⅳ级	19(25.00) 57(75.00)	89(45.41) 107(54.59)	9.528	0.002
合并症[例(%)]
高血压	52(68.42)	142(72.45)	1.032	0.310
糖尿病	24(31.58)	46(23.47)	1.884	0.170
冠心病	18(23.68)	53(27.04)	0.320	0.572
吸烟史	35(46.05)	72(36.73)	1.993	0.158
饮酒史	21(27.63)	63(32.14)	0.522	0.470
合并用药	72(94.74)	185(94.39)	0.013	0.910
总胆固醇(mmol/L)	5.82±0.65	5.71±0.58	1.356	0.176
甘油三酯(mmol/L)	2.05±0.42	1.97±0.39	1.512	0.132
低密度脂蛋白胆固醇(mmol/L)	3.25±0.71	3.12±0.68	1.397	0.163
高密度脂蛋白胆固醇(mmol/L)	1.18±0.24	1.22±0.26	1.163	0.246
空腹血糖(mmol/L)	7.96±1.25	7.78±1.19	1.104	0.271
LVEF(%)	35.26±4.18	42.58±5.32	10.771	<0.01
LVEDD(mm)	58.35±5.26	57.39±4.97	1.406	0.161

组别	例数	Tp-Te(ms)	QTcd(ms)	QRSd(ms)
MACE组	76	121.34±8.63	118.29±4.46	143.48±9.53
无MACE组	196	102.52±5.79	99.47±3.92	120.64±8.42
t值		20.785	34.159	19.334
P值		<0.01	<0.01	<0.01

组别	例数	Tp-Te(ms)	QTcd(ms)	QRSd(ms)
MACE组	76	121.34±8.63	118.29±4.46	143.48±9.53
无MACE组	196	102.52±5.79	99.47±3.92	120.64±8.42
t值		20.785	34.159	19.334
P值		<0.01	<0.01	<0.01

组别	例数	NT-proBNP (ng/L)	25-OH-VitD3 (μg/L)
MACE组	76	952.74±48.69	18.26±2.25
无MACE组	196	845.48±43.71	28.18±3.37
t值		17.581	23.683
P值		<0.01	<0.01