AUTHOR=Dai Feng , Xu Xianzhi , Zhou Chunxue , Li Cheng , Tian Zhaoxuan , Wang Zhaokai , Yang Shuping , Liao Gege , Shi Xiangxiang , Wang Lili , Li Dongye , Hou Xiancun , Chen Junhong , Xu Tongda TITLE=Development and validation of a nomogram to predict the five-year risk of revascularization for non-culprit lesion progression in STEMI patients after primary PCI JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=10 YEAR=2023 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1275710 DOI=10.3389/fcvm.2023.1275710 ISSN=2297-055X ABSTRACT=Background

Acute ST-segment elevation myocardial infarction (STEMI) patients after primary PCI were readmitted for revascularization due to non-culprit lesion (NCL) progression.

Objective

To develop and validate a nomogram that can accurately predict the likelihood of NCL progression revascularization in STEMI patients following primary PCI.

Methods

The study enrolled 1,612 STEMI patients after primary PCI in our hospital from June 2009 to June 2018. Patients were randomly divided into training and validation sets in a 7:3 ratio. The independent risk factors were determined by LASSO regression and multivariable logistic regression analysis. Multivariate logistic regression analysis was utilized to develop a nomogram, which was then evaluated for its performance using the concordance statistics, calibration plots, and decision curve analysis (DCA).

Results

The nomogram was composed of five predictors, including age (OR: 1.007 95% CI: 1.005–1.009, P < 0.001), body mass index (OR: 1.476, 95% CI: 1.363–1.600, P < 0.001), triglyceride and glucose index (OR: 1.050, 95% CI: 1.022–1.079, P < 0.001), Killip classification (OR: 1.594, 95% CI: 1.140–2.229, P = 0.006), and serum creatinine (OR: 1.007, 95% CI: 1.005–1.009, P < 0.001). Both the training and validation groups accurately predicted the occurrence of NCL progression revascularization (The area under the receiver operating characteristic curve values, 0.901 and 0.857). The calibration plots indicated an excellent agreement between prediction and observation in both sets. Furthermore, the DCA demonstrated that the model exhibited clinical efficacy.

Conclusion

A convenient and accurate nomogram was developed and validated for predicting the occurrence of NCL progression revascularization in STEMI patients after primary PCI.