Risk analysis and risk prediction of in-hospital heart failure in patients with acute myocardial infarction after emergency intervention surgery.

BACKGROUND

Percutaneous coronary intervention (PCI) can rapidly open the culprit vessels of acute myocardial infarction (AMI) and save ischemic myocardium, but it is often accompanied by a variety of complications, including heart failure (HF).Please check if the article title is presented correctlyYes, it is presented correctly OBJECTIVE: We aimed to (i) analyze the possible risk factors affecting the occurrence of in-hospital HF after emergency PCI in patients with AMI through clinical data and (ii) establish a personalized risk prediction model for the occurrence of HF after emergency PCI in patients with AMI.Please check if the author names and affiliations are captured correctlyYes, they are captured correctly METHODS: Clinical data of 676 AMI patients who consecutively underwent emergency PCI between January 2020 and October 2023 at the First Affiliated Hospital of Guangxi University of Chinese Medicine were collected. Based on whether in-hospital HF occurred after PCI, the study subjects were divided into the HF group (91 cases) and the non-HF group (585 cases). Independent risk factors were screened using univariate and multivariate logistic regression. A nomogram model of the risk of HF was drawn using R, and the discriminative power was evaluated by calculating the area under the ROC curve and drawing the calibration curve and decision curve.

RESULTS

In this study, the incidence of in-hospital HF events in AMI patients after emergency PCI was 13.46%. The analysis showed that age, troponin levels, D-dimer levels, left ventricular ejection fraction (LVEF), and Gensini score were independent predictors of the occurrence of in-hospital HF in AMI patients after emergency PCI (P < 0.05). The AUC of the nomogram model were 0.87 (95% CI: 0. 82-0.91) and 0.85 (95% CI: 0. 76-0.93) in the training and validation sets, respectively. The Hosmer-Lemeshow goodness-of-fit test in the training set suggested that the difference between predicted and actual risks of the predictive model was not statistically significant (χ = 5.8185, P = 0.6676), and this was confirmed by the Hosmer-Lemeshow goodness-of-fit test in the validation set (χ = 9.4774, P = 0.3036).

CONCLUSIONS

The predictive model for the risk of in-hospital HF in AMI patients after emergency PCI includes age, troponin levels, D-dimer levels, LVEF, and Gensini score. It has a good differentiation ability and good accuracy, it can be used to intuitively and independently screen high-risk populations, and it has high predictive value for the occurrence of HF after PCI in AMI patients, so it can be used to assist clinicians in early screening, in identifying patients at high risk of postoperative HF, and in the implementation of targeted intervention therapy.Please check if "Strengths and limitations of this study" was captured and presented correctlyYes, it was captured and presented correctly.