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Development of a simple prediction model for mechanical complication in ST-segment elevation myocardial infarction patients after primary percutaneous coronary intervention

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Abstract

Mechanical complication (MC) is a rare but serious complication in patients with ST-segment elevation myocardial infarction (STEMI). Although several risk factors for MC have been reported, a prediction model for MC has not been established. This study aimed to develop a simple prediction model for MC after STEMI. We included 1717 patients with STEMI who underwent primary percutaneous coronary intervention (PCI). Of 1717 patients, 45 MCs occurred after primary PCI. Prespecified predictors were determined to develop a tentative prediction model for MC using multivariable regression analysis. Then, a simple prediction model for MC was generated. Age ≥ 70, Killip class ≥ 2, white blood cell ≥ 10,000/µl, and onset-to-visit time ≥ 8 h were included in a simple prediction model as “point 1” risk score, whereas initial thrombolysis in myocardial infarction (TIMI) flow grade ≤ 1 and final TIMI flow grade ≤ 2 were included as “point 2” risk score. The simple prediction model for MC showed good discrimination with the optimism-corrected area under the receiver-operating characteristic curve of 0.850 (95% CI: 0.798–0.902). The predicted probability for MC was 0–2% in patients with 0–4 points of risk score, whereas that was 6–50% in patients with 5–8 points. In conclusion, we developed a simple prediction model for MC. We may be able to predict the probability for MC by this simple prediction model.

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All data are available from the corresponding author on reasonable request.

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Acknowledgements

The authors acknowledge all staff in the catheter laboratory, cardiology units, and emergency and critical care units in Saitama Medical Center, Jichi Medical University for their technical support in this study.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan

    Tsukasa Murakami, Kenichi Sakakura, Hiroyuki Jinnouchi, Yousuke Taniguchi, Takunori Tsukui, Masashi Hatori, Yusuke Tamanaha, Taku Kasahara, Yusuke Watanabe, Kei Yamamoto, Masaru Seguchi, Hiroshi Wada & Hideo Fujita

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  1. Tsukasa Murakami
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  2. Kenichi Sakakura
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  3. Hiroyuki Jinnouchi
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  4. Yousuke Taniguchi
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  5. Takunori Tsukui
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  6. Masashi Hatori
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  13. Hideo Fujita
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Correspondence to Kenichi Sakakura.

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Conflict of interest

Dr. Sakakura has received speaking honoraria from Abbott Vascular, Boston Scientific, Medtronic Cardiovascular, Terumo, OrbusNeich, Japan Lifeline, Kaneka, and NIPRO; he has served as a proctor for Rotablator for Boston Scientific, and he has served as a consultant for Abbott Vascular and Boston Scientific. Prof. Fujita has served as a consultant for Mehergen Group Holdings, Inc. Other authors have no conflicts of interest to declare.

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Murakami, T., Sakakura, K., Jinnouchi, H. et al. Development of a simple prediction model for mechanical complication in ST-segment elevation myocardial infarction patients after primary percutaneous coronary intervention. Heart Vessels 39, 288–298 (2024). https://doi.org/10.1007/s00380-023-02336-8

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