Abstract
AIM: This study developed a nomogram to predict the risk of ischemic mitral regurgitation (IMR) after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) patients and evaluate their long-term prognosis. METHODS: Data from 342 STEMI patients were collected. Logistic regression identified independent risk factors for IMR during hospitalization, while Cox regression assessed risk factors during follow-up. The nomogram was developed based on these factors. ROC evaluated its predictive value, and decision curve analysis/clinical impact curves assessed clinical utility. Kaplan-Meier analysis evaluated the model's prognostic value. RESULTS: The independent risk factors for hospitalized IMR after PCI in STEMI patients included Gensini score (OR 1.009; P = 0.047), left ventricular ejection fraction (LVEF) (OR 0.941; P = 0.007), albumin (OR 0.941; P = 0.046), and systemic immune-inflammatory index (SII) (OR 1.096; P < 0.001). During follow-up, diabetes mellitus (HR: 1.154; P = 0.019), hemoglobin (HR: 0.991; P = 0.028), Gensini score (HR: 1.007; P = 0.022), LVEF (HR: 0.972; P = 0.015), and SII/100 (HR: 1.034; P < 0.001) were identified as independent predictors of IMR. The nomogram showed strong clinical benefit, good calibration, and predictive value. Patients with lower scores had better long-term outcomes. CONCLUSION: This nomogram effectively predicts the occurrence of IMR after PCI in STEMI patients, providing valuable prognostic insights.