Nomogram Containing Simple Routine Clinical and Biochemical Parameters Can Predict Pathological Ventricular Remodeling in STEMI Patients

Abstract

BACKGROUND: Heart failure is the leading cause of worldwide morbidity and mortality, with ischemic heart disease being one of the most important etiologic factors. Heart failure develops due to ventricular remodeling, which leads to increases in left ventricular end-systolic and end-diastolic volumes.METHODS: We conducted a prospective observational study to find which parameters could predict the risk of pathological left ventricular remodeling in the early stage of myocardial infarction. RESULTS: We created a nomogram based on routinely used blood tests and vital parameters which had the highest correlation with pathological ventricular remodeling. The nomogram included NTproBNP value 12 hours after reperfusion, AST value 12 hours after reperfusion, systolic blood pressure value on admission and culprit coronary artery. We performed ROC analysis which found great predictive value of the nomogram. Area under curve (AUC) was 0,907 (95% CI 0,842 - 0,973). Nomogram value of -3.54 had sensitivity of 91.4% and specificity of 74.0%.CONCLUSION: We believe that this nomogram, once validated, could offer a widely available, low-cost option that would help identify patients at risk of developing pathological left ventricular remodeling and achieve this at a very early stage of myocardial infarction (12 hours after reperfusion is achieved).