Development and validation of a Nomogram model for predicting the risk of heart failure after percutaneous coro-nary intervention in patients with acute ST-segment elevation myocardial infarction
WANG Jun-ying
ZHAO Gui-zeng
XUE Gang
SU Shu-hong
Abstract：Objective To identify risk factors for heart failure(HF)in patients with acute ST-segment eleva-tion myocardial infarction(STEMI)undergoing percutaneous coronary intervention(PCI)and to construct and validate a predictive nomogram model.Methods A total of 424 STEMI patients treated with PCI in the Department of Cardiology between August 30,2020,and April 30,2022,were included as the modeling cohort,comprising 317 without HF and 107 with HF.Clinical characteristics including demographics,comorbidities,cardiovascular history,Killip classification,hemodynamic indices,arrhythmias,treatment regimens,and laboratory parameters(cardiac biomarkers,NT-proBNP,complete blood count,lipid profile,renal function,and fasting glucose)were collected.Logistic regression analysis was applied to determine independent risk factors.Patients meeting the same inclusion criteria during the same period but not included in the modeling cohort served as the validation cohort.Identified independent predictors were incorporated into a nomogram model using R software,with internal and external validation performed.Results Independent risk factors for HF after PCI in STEMI patients were smoking history[former smokers,quit≥1year(OR=4.440,95％CI:1.896-10.398,P＜0.001);never smokers(P=0.008)],ventricular arrhythmia(OR=2.028,95％CI:1.197-3.436,P=0.009),age＞55 years(OR=1.962,95％CI:1.079-3.569,P=0.027),NT-proBNP＞250 pg/mL(OR=2.152,95％CI:1.247-3.715,P=0.006),platelet count＜125 × 109·L-1(P＜0.001)or＞350 × 109·L-1(OR=8.905,95％CI:2.882-27.518,P＜0.001),and fasting blood glucose ≥7.0 mmol/L(OR=1.770,95％CI:1.073-2.918,P=0.025).The C-index values for internal and external validation were 0.748 and 0.727,respective-ly.The area under the receiver operating characteristic curve(AUC)for predicting HF was 0.748(95％CI:0.694-0.802)in the modeling cohort and 0.727(95％CI:0.636-0.818)in the validation cohort.Conclusion Smoking his-tory,abnormal platelet counts,age＞55 years,ventricular arrhythmia,elevated NT-proBNP,and hyperglycemia were independent predictors of HF after PCI in STEMI patients.The constructed nomogram demonstrated good predictive per-formance and may serve as a practical tool for identifying high-risk patients and guiding clinical decision-making.
Keywords：acute ST elevation myocardial infarctionpercutaneous coronary interventionheart failurerisk as-sessmentNomogram model
Publication Date：2025-09-15
Online Publishing Date：2025-11-06(First online date of this platform, not the publication date of the document)
Pages：8( 1363-1370 )