Prediction models for major adverse cardiovascular events following ST-segment elevation myocardial infarction and subgroup-specific performance

Figures

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  Figure 1. Analysis overview for identifying best-performing risk prediction model. AUC, area under the curve; NRI, net reclassification index; IDI, integrated discrimination index.

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  Figure 2. Performance evaluation of iPROMPT score and GRACE score in derivation cohort and external validation cohort. (A,D) Receiver-operating characteristic curve analysis. The accuracy for MACEs between the iPROMPT score and the GRACE risk score in the in derivation cohort (A) and external validation cohort (D). (B,E) The calibration plot shows the relationship between the observed and predicted proportion of events, grouped by quintile of risk in the in derivation cohort (B) and external validation cohort (E). (C,F) DCA curves for validating the clinical utility of the iPROMPT score and the previous model. AUC, area under the curve; GRACE, the Global Registry of Acute Coronary Events risk score; MACEs, major adverse cardiovascular events; DCA, decision curve analysis.

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  Figure 3. Association between continuous predictors and MACEs and importance of selected variables in iPROMPT. (A) The contribution of each selected variables in the iPROMPT score. (B–G) Regression-adjusted effects of selected continuous covariates in iPROMPT showed their association with MACEs following STEMI. The top of each figure shows the observed values of the continuous risk predictor among STEMI patients in the derivation cohort who experienced MACEs and the bottom shows the observed values of the predictor among those who did not experience MACEs. MACEs risk increased with age (B) and decreased LDL-C (C). MACEs risk declined with eGFR (D), and plateaued at over 100 ml/min/1.73 m2. (E) The risk associated with log(BNP) remained flat and increased when log(BNP) >5. The U-shaped association observed between hemoglobin (F), and WBC (G) and MACEs. AUC, area under the curve; BNP, B-type natriuretic peptide; eGFR, estimate glomerular filtration rate; WBC, white blood cell count.

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  Figure 4. Performance and relative importance of variables in subgroups. (A) Forest plot for AUC and 95% confidence interval depicting overall discriminative efficacy of the iPROMPT score across pre-determined subgroups; (B–D) Alluvial plot of predictors for prognosis prediction identified by variables’ contribution in sex (B), hypertensive (C) and diabetic subgroup (D). AUC, area under the curve; BNP, B-type natriuretic peptide; eGFR, estimate glomerular filtration rate; WBC, white blood cell count.