Personalized Prediction of Left Ventricular Ejection Fraction in the Follow-Up of Patients with ST-Segment Elevation Myocardial Infarction: Development of a Practical Nomogram Model-Uncorrected Proof

Objective: Accurate estimation of left ventricular ejection fraction (LVEF) after ST-segment elevation myocardial infarction (STEMI) is essential for optimizing long-term management and cardiovascular risk stratification. This study aimed to identify predictors of LVEF at six months after STEMI and to develop a clinically applicable nomogram for individualized prognostic assessment.

Method: This prospective, single-center cohort study included consecutive patients admitted with STEMI between July 2018 and October 2018. Baseline clinical, laboratory, and angiographic variables were collected. LVEF was assessed by transthoracic echocardiography during the index hospitalization and at six-month follow-up. Patients were categorized into four groups according to follow-up LVEF. Predictors of six-month LVEF were identified using proportional odds logistic regression, and a nomogram was constructed based on the final multivariable model.

Results: A total of 231 patients were analyzed (median age: 57 years; 83% male). At baseline, 119 patients (51%) had an LVEF < 50%, whereas at six months 115 patients (49%) had an LVEF < 50%. Multivariable analysis identified baseline LVEF, peak creatine kinase–myocardial band (CKMB) level, age, hypertension, and final Thrombolysis in Myocardial Infarction (TIMI) flow grade as independent predictors of follow-up LVEF (all P < 0.05).

Conclusion: Baseline LVEF and peak CK-MB level were the strongest independent predictors of six-month LVEF following STEMI. Age, hypertension, and final TIMI flow grade were identified as additional predictors. The proposed nomogram provides a practical tool for individualized follow-up planning and risk assessment in STEMI survivors.

Keywords: Left ventricular ejection fraction, nomogram, ST elevation myocardial infarction