A Nomogram Model for Predicting Type-2 Myocardial Infarction Induced by Acute Upper Gastrointestinal Bleeding

Area of Science:

• Cardiology
• Gastroenterology
• Critical Care Medicine

Background:

• Acute upper gastrointestinal bleeding (AUGIB) is a critical condition.
• AUGIB can precipitate type-2 myocardial infarction (T2MI), a significant complication.
• Identifying risk factors for AUGIB-induced T2MI is crucial for timely intervention.

Purpose of the Study:

• To determine independent risk factors for T2MI in patients experiencing AUGIB.
• To develop and validate a predictive nomogram model for AUGIB-induced T2MI.

Main Methods:

• Retrospective analysis of 533 AUGIB patients to establish a nomogram.
• Internal validation using ROC curves, AUC, calibration plots, and RMSE.
• External validation through a prospective, multicenter study of 240 AUGIB patients.

Main Results:

• Identified age >65, hemorrhagic shock, cerebral stroke, heart failure, chronic kidney disease, elevated BUN, decreased hematocrit, and elevated D-Dimer as independent risk factors.
• The nomogram demonstrated strong predictive accuracy with AUCs of 0.829 (internal) and 0.848 (external).
• Calibration curves showed good consistency between predicted and observed T2MI risk.

Conclusions:

• The developed nomogram is an effective tool for risk stratification of T2MI in AUGIB patients.
• Facilitates early identification of high-risk patients for prompt intervention.
• Particularly valuable in emergency departments and intensive care units.