{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T05:38:06Z","timestamp":1782970686203,"version":"3.54.5"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"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. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with diabetes mellitus and acute myocardial infarction (DM-AMI) are at high risk, but risk heterogeneity within this subgroup remains insufficiently characterized. Whether a parsimonious admission-based model provides prognostic information beyond GRACE remains uncertain. We aimed to assess admission risk heterogeneity in DM-AMI and develop and externally validate a model for 180-day mortality using routine variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective dual-cohort study included AMI patients from a Beijing tertiary hospital (development cohort) and an ICU-based MIMIC-IV cohort (external validation). A Cox model was built using admission variables. Model performance was evaluated using discrimination, calibration, and decision curve analysis with internal bootstrap validation and comparison with GRACE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 4,167 patients, 1,514 had DM-AMI with 90 deaths at 180 days. The model included eight variables (age, heart rate, SBP, glucose, BUN, hemoglobin, RDW, WBC). It showed good discrimination in the development cohort (C-index 0.848; AUC 0.857) and maintained performance externally (AUC 0.744). GRACE comparison showed similar discrimination, while the combined model improved performance (\u0394AUC = 0.014, P\u00a0=\u00a00.031). Calibration in MIMIC-IV indicated risk overestimation (slope 0.527; O\/E 0.652).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DM-AMI patients exhibit marked admission risk heterogeneity. The model provides complementary prognostic information beyond GRACE but requires recalibration for absolute risk use in external settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1891663","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T04:25:25Z","timestamp":1782966325000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and external validation of an admission-based model for 180-day mortality in diabetic acute myocardial infarction"],"prefix":"10.3389","volume":"17","author":[{"given":"Yanlong","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Emergency, Xuanwu Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haodong","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Emergency, Xuanwu Hospital, Capital 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