ArticleFrontiers in cardiovascular medicine2026
Development of a risk score for intramyocardial hemorrhage in elderly STEMI patients after primary PCI: a retrospective cohort study with propensity score matching analysis.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This study aimed to identify independent risk factors for intramyocardial hemorrhage (IMH) and develop a clinical risk score for predicting IMH in elderly patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods: We conducted a single-center retrospective observational study of 232 consecutive elderly patients (≥60 years) with STEMI who underwent primary PCI between August 2020 and August 2024 and completed cardiac magnetic resonance (CMR) imaging 3-7 days post-procedure. Patients were classified into IMH ( Results: The incidence of IMH was 33.2% (77/232). Multivariate logistic regression identified the following independent predictors: renal insufficiency (OR = 2.95, 95% CI: 1.41-6.18, Conclusion: IMH is common in elderly STEMI patients after primary PCI and is independently associated with renal dysfunction, extensive coronary disease, delayed reperfusion, and markers of myocardial injury. The IMH-RS score, derived from a comprehensive integration of patient comorbidities, coronary anatomy, procedural timing, and myocardial injury severity, represents a novel and practical bedside tool for early risk stratification. This integrative approach provides a more holistic risk assessment than individual predictors alone. The score may guide targeted management strategies to mitigate microvascular injury.
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