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Updated: Aug 7, 2026
Modeling and Evaluation of Murine Diabetic Cardiomyopathy Model
Published on: November 29, 2024
Development and external validation of an admission-based model for 180-day mortality in diabetic acute myocardial
Yanlong Zhao1, Haodong Jiang1, Yuanyuan Zhao1
1Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China.
Background:
Patients with diabetes mellitus and acute myocardial infarction (DM-AMI) are at high risk, but risk heterogeneity within this subgroup remains insufficiently characterized. Whether a parsimonious admission-based model provides prognostic information beyond GRACE remains uncertain. We aimed to assess admission risk heterogeneity in DM-AMI and develop and externally validate a model for 180-day mortality using routine variables.
Methods:
This retrospective dual-cohort study included AMI patients from a Beijing tertiary hospital (development cohort) and an ICU-based MIMIC-IV cohort (external validation). A Cox model was built using admission variables. Model performance was evaluated using discrimination, calibration, and decision curve analysis with internal bootstrap validation and comparison with GRACE.
Results:
Among 4,167 patients, 1,514 had DM-AMI with 90 deaths at 180 days. The model included eight variables (age, heart rate, SBP, glucose, BUN, hemoglobin, RDW, WBC). It showed good discrimination in the development cohort (C-index 0.848; AUC 0.857) and maintained performance externally (AUC 0.744). GRACE comparison showed similar discrimination, while the combined model improved performance (ΔAUC = 0.014, P = 0.031). Calibration in MIMIC-IV indicated risk overestimation (slope 0.527; O/E 0.652).
Conclusion:
DM-AMI patients exhibit marked admission risk heterogeneity. The model provides complementary prognostic information beyond GRACE but requires recalibration for absolute risk use in external settings.
