To develop and temporally validate a clinical prediction model for left ventricular aneurysm (LVA) in STEMI patients undergoing primary percutaneous coronary intervention (pPCI).
Approach:
Study Design: A retrospective cohort study including 1,245 STEMI patients for model development and 310 for temporal validation.
Statistical Analysis: Used restricted cubic spline analysis, LASSO regression, multivariable logistic regression, ROC curve, calibration curve, DCA, and nomogram for model development and validation.
Key Findings:
High fibrinogen-to-albumin ratio (FAR) was independently associated with LVA (OR = 2.10, 95% CI: 1.09–4.04, P = 0.027).
The combined model of FAR, left ventricular ejection fraction (LVEF), and NT-proBNP showed high discrimination (AUC = 0.933, 95% CI: 0.914–0.952).
The model retained excellent performance in the temporal validation cohort (AUC = 0.934, 95% CI: 0.894–0.974).
Interpretation:
Elevated FAR is associated with an increased risk of LVA in STEMI patients following pPCI.
Limitations:
Retrospective design may introduce selection bias.
The temporal validation cohort was not involved in model fitting or variable selection.
Conclusion:
Elevated FAR is associated with an increased risk of LVA in STEMI patients.
