Key result
A prediction model using cardiac troponin I, myoglobin, LVEDD, multivessel disease, and no-reflow predicted nonrecovery of LVEF in AMI patients with AUCs of 0.703 and 0.665.
Why the study?
Risk factors for nonrecovery of LVEF during follow-up in patients with AMI undergoing PCI combined with reduced LVEF needed investigation to establish and verify a risk prediction model.
Can a LASSO regression-based prediction model accurately predict nonrecovery of LVEF in patients with AMI and reduced LVEF undergoing PCI?
Cohort
Randomly assigned to establishment and validation cohorts
No
Can a LASSO regression-based prediction model accurately predict nonrecovery of LVEF in patients with AMI and reduced LVEF undergoing PCI?
A prediction model using clinical, biomarker, and angiographic variables provides moderate predictive ability for identifying AMI patients at risk of persistent LVEF reduction after PCI.
Model shows moderate accuracy for LVEF nonrecovery post-AMI; leaves open clinical utility pending prospective validation.
BACKGROUND: This study aimed to investigate the risk factors for nonrecovery of left ventricular ejection fraction (LVEF) during follow-up in patients with acute myocardial infarction (AMI) who underwent percutaneous coronary intervention (PCI) combined with reduced LVEF, and establish and verify a risk prediction model based on these factors. METHODS: In this study, patients with AMI who underwent PCI in a high-volume PCI center between December 2018 and December 2021 were consecutively enrolled, screened, and randomly assigned to the model establishment and validation cohorts. A predictive model method based on least absolute shrinkage and selection operator regression was used for establishment and validation. RESULTS: Cardiac troponin I, myoglobin, left ventricular end-diastolic dimension, multivessel disease, and no-reflow were identified as potential predictors of LVEF recovery failure. The areas under the curve were 0.703 and 0.665 in the model establishment and validation cohorts, respectively, proving that the prediction model had some predictive ability. The calibration curves of the two cohorts showed good agreement with those of the nomogram model. In addition, the decision curve analysis showed that the model had a net clinical benefit. CONCLUSION: This prediction model can assess the risk of nonrecovery of LVEF in patients with AMI undergoing PCI combined with LVEF reduction during follow-up, and conveniently screen high-risk patients with nonrecoverable LVEF early.
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Yang et al. (2024) conducted a cohort in Acute myocardial infarction (AMI) with reduced LVEF. Prediction model (LASSO regression) was evaluated on Nonrecovery of left ventricular ejection fraction (LVEF). A prediction model using cardiac troponin I, myoglobin, LVEDD, multivessel disease, and no-reflow predicted nonrecovery of LVEF in AMI patients with AUCs of 0.703 and 0.665.
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