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. 2024 Feb;47(2):e24212.
doi: 10.1002/clc.24212.

Establishment and validation of a prediction model for nonrecovery of left ventricular ejection fraction in acute myocardial infarction patients combined with decreased left ventricular ejection fraction

Yang Yang  1 , You Zheng Dong  1 , An Xue Hou  1 , De Ping Liu  1 , Jin Wu He  1 , Jun Ye Chen  1 , Xing Hua Jiang  1
Affiliations

Establishment and validation of a prediction model for nonrecovery of left ventricular ejection fraction in acute myocardial infarction patients combined with decreased left ventricular ejection fraction

Yang Yang et al. Clin Cardiol. 2024 Feb.

Abstract

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.

Keywords: acute myocardial infarction; left ventricular ejection fraction; nomogram; percutaneous coronary intervention; prediction model.

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Figures

Figure 1
Figure 1
Study cohort flow diagram. AMI, acute myocardial infarction; LVEF, left ventricular ejection fraction; PCI, percutaneous coronary intervention.
Figure 2
Figure 2
(A) The distribution of LASSO regression coefficients for 47 variables. (B) Penalty plot for the LASSO model. (C) A nomogram of nonrecovery of LVEF. (D) ROC curve of model establishment cohort. (E) ROC curve of model validation cohort. AUC, areas under the curve; cTnI, troponin I; LASSO, least absolute shrinkage and selection operator; LVEDD, left ventricular end‐diastolic dimension; LVEF, left ventricular ejection fraction; ROC, receiver operating characteristic curve.
Figure 3
Figure 3
(A) Calibration curve for the model establishment cohort. (B) Calibration curve for the model validation cohort. (C) DCA curve for the model establishment cohort. (D) DCA curve for the model validation cohort. DCA, decision curve analysis.
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