Erector spinae density as a predictor of early cardiac complications in patients with stroke.

RATIONALE AND OBJECTIVES: The relationship between erector spinae muscle density (ESMD) and early cardiovascular complications in patients with stroke remains unexplored. Therefore, this study aimed to evaluate the predictive value of ESMD, assessed through chest computed tomography (CT), for the incidence of stroke-heart syndrome (SHS) in patients with stroke. MATERIALS AND METHODS: Clinical data of 422 patients with stroke from Zhejiang Provincial People's Hospital (January 2023-March 2024) were retrospectively analyzed. Patients were grouped based on the presence of SHS within 72 h of admission. Logistic regression analyses identified predictors, and a nomogram integrating ESMD was constructed. Model performance was evaluated through receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis. RESULTS: Independent predictors of SHS included the ESMD, serum albumin level, estimated glomerular filtration rate, prothrombin time, and fibrinogen level (P < 0.001). Lower ESMD (<34.39 HU) significantly correlated with a higher SHS risk, with ROC analysis showing an area under the curve (AUC) of 0.741. The ESMD-integrated nomogram demonstrated excellent predictive performance (AUC = 0.815) and clinical utility. CONCLUSION: ESMD obtained from chest CT is a strong predictor of SHS, offering a practical, non-invasive marker for early risk stratification and management. The proposed nomogram provides an effective tool for identifying and managing patients at high risk of SHS.