{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T06:19:10Z","timestamp":1783059550496,"version":"3.54.6"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a single-center retrospective observational study of 232 consecutive elderly patients (\u226560 years) with STEMI who underwent primary PCI between August 2020 and August 2024 and completed cardiac magnetic resonance (CMR) imaging 3\u20137 days post-procedure. Patients were classified into IMH (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200977) and non-IMH (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009155) groups based on CMR findings. Clinical, laboratory, angiographic, and procedural data were collected. Univariate and multivariate logistic regression analyses were performed to identify independent predictors. A risk score (IMH-RS) was developed and validated internally.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The incidence of IMH was 33.2% (77\/232). Multivariate logistic regression identified the following independent predictors: renal insufficiency (OR\u2009=\u20092.95, 95% CI: 1.41\u20136.18,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004), left anterior descending artery involvement (OR\u2009=\u20092.01, 95% CI: 1.02\u20133.97,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.044), door-to-balloon time &amp;gt;45\u2005min (OR\u2009=\u20092.55, 95% CI: 1.36\u20134.78,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003), triple-vessel disease (OR\u2009=\u20096.12, 95% CI: 2.51\u201314.88,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), elevated B-type natriuretic peptide (per 100\u2005pg\/L increase: OR\u2009=\u20091.25, 95% CI: 1.05\u20131.49,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.012), and reduced left ventricular ejection fraction (per 1% increase: OR\u2009=\u20090.94, 95% CI: 0.91\u20130.97,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). An integer-based risk score (IMH-RS) ranging from 0 to 10 was developed, demonstrating good discrimination (AUC\u2009=\u20090.82, 95% CI: 0.77\u20130.87) and effectively stratifying patients into low- (12.5% IMH), intermediate- (38.2%), and high-risk (68.9%) groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1786172","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T05:39:08Z","timestamp":1783057148000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development of a risk score for intramyocardial hemorrhage in elderly STEMI patients after primary PCI: a retrospective cohort study with propensity score matching analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Rui","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Hebei North University","place":["Zhangjiakou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuijun","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Hebei North University","place":["Zhangjiakou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaqi","family":"Liu","sequence":"additional","affiliation":[{"name":"Graduate School, Hebei North University","place":["Zhangjiakou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanshuai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Hebei North University","place":["Zhangjiakou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoqiang","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Hebei North University","place":["Zhangjiakou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/j.jcmg.2024.02.003","article-title":"Microvascular obstruction and intramyocardial hemorrhage in reperfused myocardial infarctions: pathophysiology and clinical insights from imaging","volume":"17","author":"Vora","year":"2024","journal-title":"Cardiovasc Imaging"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2052","DOI":"10.1016\/j.jacc.2024.03.408","article-title":"Clinical outcomes associated with various microvascular injury patterns identified by CMR after STEMI","volume":"83","author":"Lechner","year":"2024","journal-title":"J Am Coll Cardiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e038727","DOI":"10.1161\/JAHA.124.038727","article-title":"Inpatient-onset versus outpatient-onset ST-segment\u2013elevation myocardial infarction in patients 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