Predictors of Coronary Collateral Circulation in Patients with Acute ST-segment Elevation Myocardial Infarction: A Nomogram-based Approach
Background: Coronary collateral circulation (CCC) is a crucial protective mechanism in acute myocardial infarction. This study aimed to identify early predictors of CCC in patients with acute ST-segment elevation myocardial infarction (STEMI) and develop a nomogram for predicting...
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IMR Press
2025-04-01
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| Series: | Reviews in Cardiovascular Medicine |
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| Online Access: | https://www.imrpress.com/journal/RCM/26/4/10.31083/RCM26477 |
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| author | Hongxia Shao Wenling Zhao Zhao Li Xingchen Song Ruifeng Liu |
| author_facet | Hongxia Shao Wenling Zhao Zhao Li Xingchen Song Ruifeng Liu |
| author_sort | Hongxia Shao |
| collection | DOAJ |
| description | Background: Coronary collateral circulation (CCC) is a crucial protective mechanism in acute myocardial infarction. This study aimed to identify early predictors of CCC in patients with acute ST-segment elevation myocardial infarction (STEMI) and develop a nomogram for predicting its presence. Methods: We conducted a retrospective study of STEMI patients admitted to the Beijing Friendship Hospital from January 2015 to December 2023. Patients with CCC, as confirmed by coronary angiography, were matched 1:3 with those without CCC based on the date of admission. We compared baseline characteristics, laboratory parameters, coronary features, and in-hospital outcomes between the two groups. Variable selection was performed using least absolute shrinkage and selection operator (LASSO) regression analysis, followed by univariable and multivariable logistic regression analyses to identify independent predictors of CCC. A nomogram was constructed based on significant predictors and was validated through receiver operating characteristic (ROC) curve analysis, calibration curves, and decision curve analysis. Results: A total of 668 patients with STEMI were included in the study (501 without CCC and 167 with CCC). Patients with CCC had a higher prevalence of right coronary artery (RCA) closure and multi-vessel disease, as well as elevated inflammatory markers and altered coagulation parameters. Multivariable logistic regression analysis identified a history of coronary heart disease (CHD), osmolality, levels of fibrinogen, and left anterior descending (LAD) artery closure, left circumflex (LCX) artery closure, and RCA closures, as well as the Gensini score, were independent predictors of CCC. The nomogram incorporating these predictors demonstrated good discrimination and calibration, indicating an accurate prediction of the presence of CCC. Conclusions: History of CHD, osmolality, levels of fibrinogen, LAD, LCX, and RCA closures, as well as the Gensini score, are independent predictors of CCC in patients with STEMI. The developed nomogram offers a clinically useful tool for identifying patients likely to have CCC, potentially aiding in personalized treatment strategies. |
| format | Article |
| id | doaj-art-6449f181de4c4e5eac9fb132fbaaefdd |
| institution | OA Journals |
| issn | 1530-6550 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj-art-6449f181de4c4e5eac9fb132fbaaefdd2025-08-20T01:48:21ZengIMR PressReviews in Cardiovascular Medicine1530-65502025-04-012642647710.31083/RCM26477S1530-6550(24)01717-4Predictors of Coronary Collateral Circulation in Patients with Acute ST-segment Elevation Myocardial Infarction: A Nomogram-based ApproachHongxia Shao0Wenling Zhao1Zhao Li2Xingchen Song3Ruifeng Liu4Department of Cardiology, The People’s Hospital of Dangshan County, 235300 Suzhou, Anhui, ChinaDepartment of Cardiology, The People’s Hospital of Dangshan County, 235300 Suzhou, Anhui, ChinaDepartment of Cardiology, The People’s Hospital of Dangshan County, 235300 Suzhou, Anhui, ChinaDepartment of Cardiology, The People’s Hospital of Dangshan County, 235300 Suzhou, Anhui, ChinaDepartment of Cardiology, Beijing Friendship Hospital, Capital Medical University, 100050 Beijing, ChinaBackground: Coronary collateral circulation (CCC) is a crucial protective mechanism in acute myocardial infarction. This study aimed to identify early predictors of CCC in patients with acute ST-segment elevation myocardial infarction (STEMI) and develop a nomogram for predicting its presence. Methods: We conducted a retrospective study of STEMI patients admitted to the Beijing Friendship Hospital from January 2015 to December 2023. Patients with CCC, as confirmed by coronary angiography, were matched 1:3 with those without CCC based on the date of admission. We compared baseline characteristics, laboratory parameters, coronary features, and in-hospital outcomes between the two groups. Variable selection was performed using least absolute shrinkage and selection operator (LASSO) regression analysis, followed by univariable and multivariable logistic regression analyses to identify independent predictors of CCC. A nomogram was constructed based on significant predictors and was validated through receiver operating characteristic (ROC) curve analysis, calibration curves, and decision curve analysis. Results: A total of 668 patients with STEMI were included in the study (501 without CCC and 167 with CCC). Patients with CCC had a higher prevalence of right coronary artery (RCA) closure and multi-vessel disease, as well as elevated inflammatory markers and altered coagulation parameters. Multivariable logistic regression analysis identified a history of coronary heart disease (CHD), osmolality, levels of fibrinogen, and left anterior descending (LAD) artery closure, left circumflex (LCX) artery closure, and RCA closures, as well as the Gensini score, were independent predictors of CCC. The nomogram incorporating these predictors demonstrated good discrimination and calibration, indicating an accurate prediction of the presence of CCC. Conclusions: History of CHD, osmolality, levels of fibrinogen, LAD, LCX, and RCA closures, as well as the Gensini score, are independent predictors of CCC in patients with STEMI. The developed nomogram offers a clinically useful tool for identifying patients likely to have CCC, potentially aiding in personalized treatment strategies.https://www.imrpress.com/journal/RCM/26/4/10.31083/RCM26477coronary collateral circulationacute st-segment elevation myocardial infarctionpredictorsnomogramgensini score |
| spellingShingle | Hongxia Shao Wenling Zhao Zhao Li Xingchen Song Ruifeng Liu Predictors of Coronary Collateral Circulation in Patients with Acute ST-segment Elevation Myocardial Infarction: A Nomogram-based Approach Reviews in Cardiovascular Medicine coronary collateral circulation acute st-segment elevation myocardial infarction predictors nomogram gensini score |
| title | Predictors of Coronary Collateral Circulation in Patients with Acute ST-segment Elevation Myocardial Infarction: A Nomogram-based Approach |
| title_full | Predictors of Coronary Collateral Circulation in Patients with Acute ST-segment Elevation Myocardial Infarction: A Nomogram-based Approach |
| title_fullStr | Predictors of Coronary Collateral Circulation in Patients with Acute ST-segment Elevation Myocardial Infarction: A Nomogram-based Approach |
| title_full_unstemmed | Predictors of Coronary Collateral Circulation in Patients with Acute ST-segment Elevation Myocardial Infarction: A Nomogram-based Approach |
| title_short | Predictors of Coronary Collateral Circulation in Patients with Acute ST-segment Elevation Myocardial Infarction: A Nomogram-based Approach |
| title_sort | predictors of coronary collateral circulation in patients with acute st segment elevation myocardial infarction a nomogram based approach |
| topic | coronary collateral circulation acute st-segment elevation myocardial infarction predictors nomogram gensini score |
| url | https://www.imrpress.com/journal/RCM/26/4/10.31083/RCM26477 |
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