Age and Mean Platelet Volume-based Nomogram for Predicting the Therapeutic Efficacy of Metoprolol in Chinese Pediatric Patients with Vasovagal Syncope

Overview

Journal World J Pediatr

Specialty Pediatrics

Date 2024 Apr 13

PMID 38613734

Authors

Xiao-Juan Du

Ya-Qian Huang

Xue-Ying Li

Ying Liao

Hong-Fang Jin

Jun-Bao Du

Affiliations

Soon will be listed here.

Abstract

Background: Vasovagal syncope (VVS) is the most common type of orthostatic intolerance in children. We investigated whether platelet-related factors related to treatment efficacy in children suffering from VVS treated with metoprolol.

Methods: Metoprolol-treated VVS patients were recruited. The median duration of therapy was three months. Patients were followed and divided into two groups, treament-effective group and treatment-ineffective group. Logistic and least absolute shrinkage selection operator regressions were used to examine treatment outcome variables. Receiver-operating characteristic (ROC) curves, precision-recall (PR) curves, calibration plots, and decision curve analyses were used to evaluate the nomogram model.

Results: Among the 72 patients who complete the follow-up, treatment-effective group and treatment-ineffective group included 42 (58.3%) and 30 (41.7%) cases, respectively. The patients in the treatment-effective group exhibited higher mean platelet volume (MPV) [(11.0 ± 1.0) fl vs. (9.8 ± 1.0) fl, P < 0.01] and platelet distribution width [12.7% (12.3%, 14.3%) vs. 11.3% (10.2%, 12.2%), P < 0.01] than those in the treatment-ineffective group. The sex ratio was significantly different (P = 0.046). A fit model comprising age [odds ratio (OR) = 0.766, 95% confidence interval (CI) = 0.594-0.987] and MPV (OR = 5.613, 95% CI = 2.297-13.711) might predict therapeutic efficacy. The area under the curve of the ROC and PR curves was computed to be 0.85 and 0.9, respectively. The P value of the Hosmer-Lemeshow test was 0.27. The decision curve analysis confirmed that managing children with VVS based on the predictive model led to a net advantage ranging from 0.01 to 0.58. The nomogram is convenient for clinical applications.

Conclusion: A novel nomogram based on age and MPV can predict the therapeutic benefits of metoprolol in children with VVS.

Citing Articles

Malignant vasovagal syncope in children.

Xu W, Jin H, Du J, Liao Y World J Pediatr. 2024; 21(1):41-47.

PMID: 39695047 DOI: 10.1007/s12519-024-00867-2.

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