Related Experiment Video
Updated: May 6, 2026
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Nomogram to Predict Outcomes After Staged Revascularization in ST-Segment Elevation Myocardial Infarction and
Huaigen Wang1, Aiqun Ma1,2, Tingzhong Wang1,2
1Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
Insights
This study developed predictive models and nomograms for patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MVD). These tools help identify low-risk patients, improving outcomes after percutaneous coronary intervention (PCI).
Area of Science:
- Cardiology
- Medical Informatics
- Predictive Modeling
Background:
- Multivessel coronary artery disease (MVD) affects approximately 50% of ST-segment elevation myocardial infarction (STEMI) patients.
- Management strategies for STEMI patients with MVD are controversial, necessitating improved risk stratification.
Purpose of the Study:
- To develop predictive models and a nomogram for outcomes in STEMI patients with MVD.
- To aid in the identification and classification of patient risk for better management.
Main Methods:
- Least Absolute Shrinkage and Selection Operator (LASSO) regression for feature selection.
- Cox regression modeling and nomogram construction.
- Kaplan-Meier survival analysis to compare low- and high-risk groups.
Main Results:
- Models demonstrated good predictive accuracy with C-indices of 0.68 for MACE-free survival and 0.75 for overall survival.
- Low-risk patients exhibited significantly lower 1- and 3-year MACE and all-cause death rates compared to high-risk patients.
- Nomogram predictions correlated well with observed patient outcomes.
Conclusions:
- Developed nomograms provide a practical tool for predicting outcomes in STEMI patients with MVD undergoing primary and staged PCI.
- These nomograms can assist clinicians in risk stratification and treatment planning for improved patient management.
Objective:
Approximately 50% of ST-segment elevation myocardial infarction (STEMI) patients have multivessel coronary artery disease (MVD). The management strategy for these patients remains controversial. This study aimed to develop predictive models and nomogram of outcomes in STEMI patients with MVD for better identification and classification.
Methods:
The least absolute shrinkage and selection operator (LASSO) method was used to select the features most significantly associated with the outcomes. A Cox regression model was built using the selected variables. One nomogram was computed from each model, and individual risk scores were obtained by applying the nomograms to the cohort. After regrouping patients based on nomogram risk scores into low- and high-risk groups, we used the Kaplan-Meier method to perform survival analysis.
Results:
The C-index of the major adverse cardiovascular event (MACE)-free survival model was 0·68 (95% CI 0·62-0·74) and 0·65 [0·62-0·68]) at internal validation, and that of the overall survival model was 0·75 (95% CI 0·66-0·84) and (0·73 [0·65-0·81]). The predictions of both models correlated with the observed outcomes. Low-risk patients had significantly lower probabilities of 1-year or 3-year MACEs (4% versus 11%, P= 0.003; 7% versus 15%, P=0.01, respectively) and 1-year or 3-year all-cause death (1% versus 3%, P=0.048; 2% versus 7%, respectively, P=0.001) than high-risk patients.
Conclusion:
Our nomograms can be used to predict STEMI and MVD outcomes in a simple and practical way for patients who undergo primary PCI for culprit vessels and staged PCI for non-culprit vessels.
More Related Videos
07:25Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
06:46Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Related Concept Videos
01:23Dosage Regimen Designs: Nomograms and Tabulations
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:30Acute Coronary Syndrome III: Diagnostic Studies