The association between the MELD-XI score and heart failure in patients with acute myocardial infarction after coronary artery stenting-a retrospective study

Abstract

Background The model for end-stage liver disease (MELD) score is a marker used to evaluate end-stage liver disease in patients with liver failure and is suggested to be valuable in evaluating heart diseases such as heart failure. Because patients with heart failure and myocardial infarction often use anticoagulants, there is an impact on the international normalized ratio (INR). Therefore, removing the INR from MELD score to form MELD-XI score may help to more accurately evaluate the cardiac function in patients with heart failure. This study was conducted to examine the predictive value of MELD-XI score in patients with acute myocardial infarction after coronary artery stenting, as there is a lack of literature in this area. Methods The data of 318 patients with acute myocardial infarction admitted to The People’s Hospital of Dazu from January 2018 to January 2021 was retrospectively collected. According to the MELD-XI score on admission, the patients were divided into a high-MELD-XI score group (n=159) and a low-MELD-XI score group (n=159). The patients were followed up for 1 year after surgery to observe the long-term prognosis and the long-term prognosis of the 2 groups was compared. Results Compared with that in the low-MELD-XI score group, the left ventricular ejection fraction in the high-MELD-XI score group was significantly reduced (51.61%±7.66% vs. 60.48%±5.94%; P<0.001), while the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) increased significantly (821.58±461.81 vs. 723.51±335.16 ng; P=0.031). The MELD-XI score had a certain predictive value for heart failure in patients with acute myocardial infarction after coronary artery stenting, and the area under the curve was 0.730 (95% CI: 0.670–0.791; P<0.001). The MELD-XI score had a predictive value for death in patients with acute myocardial infarction after coronary artery stenting, and the area under the curve was 0.704 (95% CI: 0.564–0.843; P=0.022). MELD-XI score was significantly negatively correlated with left ventricular ejection fraction in patients with acute myocardial infarction after coronary artery stenting (r=–0.444; P<0.001). Conclusions MELD-XI could evaluate the cardiac function of patients with acute myocardial infarction after coronary artery stenting, which was valuable in predicting the prognosis.