Construction of a Column Chart Prediction Model for the Risk of Left Ventricular Thrombosis After PCI in Patients with Acute ST Segment Elevation Myocardial Infarction

Xianglian Bai,1 Aiwu Luo,2 Qin Liu,1 Xiaofeng Ma1 1The Affiliated Nanhua Hospital, Department of Cardiology, Hengyang Medical School, University of South China, Hengyang City, Hunan Province, 421001, People’s Republic of China; 2Department of Health Education, Hengyang Center for Disease Control and Prevention, Hengyang City, 421002, People’s Republic of ChinaCorrespondence: Xiaofeng Ma, The Affiliated Nanhua Hospital, Department of Cardiology, Hengyang Medical School, University of South China, Dongfeng Street, Zhuhui District, Hengyang City, Hunan Province, People’s Republic of China, Tel + 8613786437543, Email [email protected]: To explore the influencing factors of left ventricular thrombosis after percutaneous coronary intervention (PCI) in patients with acute ST segment elevation myocardial infarction (STEMI) and construct a column chart model.Methods: A retrospective study was conducted on 331 STEMI patients who underwent PCI between July 2020 and January 2024. According to the principle of approximately 3:1, patients were randomly separated into 245 in the modeling group and 86 in the validation group, and clinical data of patients were collected. Multivariate logistic regression was applied to screen for risk factors. R software was applied to draw column charts. Bootstrap method was applied for internal validation. Hosmer-Lemeshow (H-L) was applied to test the fitting degree of the column chart model. Calibration curve and ROC curve were applied to verify calibration and discrimination, respectively. DCA curve was applied to analyze the clinical practicality of the column chart model.Results: A history of angina pectoris, ventricular aneurysm, alcohol abuse, postoperative TIMI grade ≤ 2, LVEF, and total ischemic time were influencing factors for left ventricular thrombosis in STEMI patients after PCI (P< 0.05). The predicted probabilities of the internal and external validation calibration curves were highly consistent with the actual probabilities, the concordance index of the ROC curve was 0.962 (95% CI: 0.931– 0.994) and 0.958 (95% CI: 0.926– 0.990), respectively, indicating high model calibration and discrimination; H-L inspection showed χ2=11.977, 9.757 (P=0.152, 0.282). DCA curve showed that when the probability range of the high-risk threshold was 0.02~0.99, the column chart model performed better and had a higher net return.Conclusion: The column chart model constructed by risk factors such as history of angina, ventricular aneurysm, history of alcohol abuse, postoperative TIMI ≤ grade 2, LVEF, and total ischemic time has high predictive value and can effectively predict left ventricular thrombosis in STEMI patients after PCI.Keywords: acute ST-segment elevation myocardial infarction, percutaneous coronary intervention, left ventricular thrombosis, influencing factors, column chart