Identification of the prognostic horizon of the predictive model of risk of cardiac complications in patients with acute myocardial infarction

Authors

Abstract

The proposed predictive model for in-hospital cardiac complications in patients with acute myocardial infarction stands out for its prognostic horizon (24-48 h post-admission), based on clinical and echocardiographic variables (LVEF ≤40%, RV TDI ≤9.5 cm/s, IAP ≥15 mmHg), with high sensitivity (89.68%) and positive predictive value (94.17%), although limited by moderate specificity (79.41%) and low negative predictive value (67.50%). It outperforms traditional models (GRACE, TIMI) by integrating structural parameters, but its dependence on echocardiography restricts its use in resource-limited settings. Calibration (Hosmer-Lemeshow, p=0.760) and Nagelkerke R² (0.65) support its fit, although 34% of variability remains unexplained. Its validity in contexts outside of Cuba (thrombolytic therapy vs. angioplasty) requires external validation. Although useful for early stratification and optimization of care, its implementation requires adaptation to local conditions, technical training, and consideration of socioeconomic factors.

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Author Biographies

Lodixi Cobas Planchez, Hospital Clinico Quirurgico Hermanos Ameijeiras

Departamento de Cirugía Cardiovascular. Doctor en Ciencias Médicas.

Natascha Mezquia de Pedro , Facultad de Ciencias Médicas "Dr. Miguel Enríquez"

Doctora en Ciencias Médicas.

References

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Published

2025-06-27

How to Cite

1.
Cobas Planchez L, Mezquia de Pedro N. Identification of the prognostic horizon of the predictive model of risk of cardiac complications in patients with acute myocardial infarction. Rev Cubana Med Milit [Internet]. 2025 Jun. 27 [cited 2025 Jun. 29];54(3):e025076533. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/76533

Issue

Vol. 54 No. 3 (2025): July - September (In Progress)

Section

Letter to the Editor

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Copyright (c) 2025 Lodixi Cobas Planchez, Natascha Mezquia de Pedro

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