Prognostic value of TIMI risk score combined with systemic immune-inflammation index and lipoprotein(a) in patients with ST-Segment elevation myocardial infarction after percutaneous coronary intervention

Abstract

Background

Thrombolysis in Myocardial Infarction (TIMI) risk score in patients with ST-segment elevation myocardial infarction (STEMI) is associated with major adverse cardiovascular events (MACE). This study aimed to develop a prediction model based on the TIMI risk score for MACE in STEMI patients after percutaneous coronary intervention (PCI).

Methods

We conducted a retrospective data analysis on 290 acute STEMI patients admitted to the Affiliated Hospital of Yangzhou University from January 2022 to June 2023 and met the inclusion criteria. The primary endpoint was the occurrence of MACE. Multivariate logistic regression was used to identify independent predictors that could predict the likelihood of MACE, and R software was utilized to construct and validate the prediction model.

Results

Systemic immune-inflammation index (SII), lipoprotein(a) [Lp(a)], and TIMI risk score were identified as independent risk factors for MACE in STEMI patients (p < 0.05). A nomogram was constructed based on these factors. The area under the receiver operating characteristic curve values for the training and validation sets were 0.883 (95 % CI: 0.836–0.930) and 0.841 (95 % CI: 0.756–0.925), respectively. The calibration curves displayed a high consistency between prediction and observation in the training and validation sets. Additionally, decision curve analysis (DCA) demonstrated the clinical usefulness of the nomogram.

Conclusions

SII, Lp(a), and TIMI risk score are independent risk factors for MACE within one year in STEMI patients after PCI. Incorporating SII and Lp(a) into the TIMI risk score enhances the predictive value for adverse outcomes, thereby supporting healthcare professionals in clinical decision-making.