Key result
Nomogram incorporating TIMI 0, LV diameter, and anterior MI predicts LV thrombus with ~0.79 AUC.
Why the study?
To identify factors influencing left ventricular thrombus development in patients with left ventricular aneurysm after acute myocardial infarction and establish a nomogram prediction model for individual assessment.
Can a nomogram based on clinical and imaging variables accurately predict the development of left ventricular thrombus in patients with left ventricular aneurysm after acute myocardial infarction?
Observational (n=163)
No
Can a nomogram based on clinical and imaging variables accurately predict the development of left ventricular thrombus in patients with left ventricular aneurysm after acute myocardial infarction?
Effect estimate: AUC 0.792 (95% CI 0.710-0.874)
p-value: p=<0.01
A novel nomogram incorporating preoperative TIMI 0 flow, left ventricular diameter, and anterior wall MI location provides good predictive accuracy for left ventricular thrombus in patients with post-AMI left ventricular aneurysm.
Nomogram may aid LVT risk stratification in post-AMI LVA; prospective validation required before clinical adoption.
Background: To identify the factors influencing the development of a left ventricular thrombus (LVT) in patients with a left ventricular aneurysm (LVA) after acute myocardial infarction (AMI) and to utilize these variables to establish a new nomogram prediction model for individual assessment in LVT. Methods: We screened data on 1268 cases of LVA at the China-Japan Union Hospital of Jilin University between January 1, 2018 and December 31, 2023, and identified a total of 163 LVAs after AMI. The independent risk factors of LVT in patients with LVA after AMI were identified from univariable and multivariable logistic regression analyses and a nomogram prediction model of LVT was established with independent risk factors as predictors. We used the area under the curve (AUC) and a calibration curve to determine the predictive accuracy and discriminability of nomograms. Furthermore, decision curve analysis (DCA) was utilized to further validate the clinical effectiveness of the nomogram. Results: Multivariate logistic regression analysis identified that preoperative thrombus in myocardial infarction 0, left ventricular diameter, and anterior wall myocardial infarction were independent risk factors of LVT in patients with LVA after AMI (p < 0.05). The nomogram prediction model constructed using these variables demonstrates exceptional performance, as evidenced by well-calibrated plots, favorable results from DCA, and the AUC of receiver operating characteristic (ROC) analysis was 0.792 (95% CI: 0.710–0.874, p < 0.01). Conclusions: A new nomogram prediction model was developed to enable precise estimation of the probability of LVT in patients with LVA after AMI, thereby facilitating personalized clinical decision-making for future practice.
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Xu et al. (2024) conducted an observational in Left ventricular aneurysm after acute myocardial infarction (n=163). Preoperative TIMI 0, left ventricular diameter, and anterior wall myocardial infarction vs. Absence of these risk factors was evaluated on Prediction of left ventricular thrombus (Area Under the Curve) (AUC 0.792, 95% CI 0.710-0.874, p=<0.01). A nomogram prediction model incorporating preoperative TIMI 0, left ventricular diameter, and anterior wall myocardial infarction accurately predicted the probability of left ventricular thrombus (AUC 0.792).
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