PONE-D-24-46383Development of a multidimensional prediction model for long-term prognostic risk in patients with acute coronary syndromes after percutaneous coronary intervention�a retrospective observational cohort studyPLOS ONE

Dear Dr. Cao,

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Reviewers' comments:

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Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

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Reviewer #1: Yes

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Reviewer #1: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The presented study focuses on the development of a multidimensional predictive model for assessing long-term survival in patients who have undergone percutaneous coronary angioplasty following acute coronary syndromes. This is a cohort, observational study. The study included patients treated for myocardial infarction and unstable angina. The model was developed using selected laboratory and clinical parameters as well as indicators related to patients' physical activity. It appears that the ability to engage in physical activity and record its intensity determined the characteristics of the studied population and the values of EF and EDLV. The study was conducted correctly, and the statistical analysis was performed appropriately. However, the article requires several revisions and clarifications.

1. The authors must decide whether they intend to use the term fasting blood sugar or fasting plasma glucose, as both are used interchangeably throughout the article.

2. The authors must specify whether the reported values of laboratory and echocardiographic parameters were measured at admission, at discharge, or averaged.

o The EF values in AMI are surprisingly high: EF (%), (IQR) 57.00 (55.00,60.00) 58.00 (53.00,60.00).

3. The presented study has several limitations that require description: a. The variables did not include troponin levels. b. The duration of ischemia was not considered. c. The number of affected coronary arteries was not included. d. The type of myocardial infarction was not specified, i.e., whether it was an ST-elevation myocardial infarction (STEMI) or a non-ST-elevation myocardial infarction (NSTEMI). e. The study was conducted, and consequently, the model was developed based on a relatively small population. f. The hemodynamic status of patients at hospital admission (Killip-Kimball classification) was not considered.

4. It is recommended to expand the discussion section with references to other studies describing the significance of laboratory indicators in cardiovascular risk assessment, for example: a. https://doi.org/10.1016/j.ijcard.2024.132663. b. https://doi.org/10.1093/eurheartj/ehae666.1571.

5. Considering the descriptive characteristics of the AMI group, the authors should reconsider modifying the title and approach to the model as a predictive model for assessing long-term prognosis in patients with preserved ejection fraction.

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Reviewer #1: No

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Development of a multidimensional prediction model for long-term prognostic risk in patients with acute coronary syndromes after percutaneous coronary intervention�a retrospective observational cohort study

PONE-D-24-46383R1

Dear Dr. Cao,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Giuseppe Andò, M.D., Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The manuscript has been revised according to the reviewer's suggestions. This predictive model should be verified with a large sample. A variable such as ejection fraction should play an important role in long-term prognosis after ACS.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy .

Reviewer #1: No

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