BackgroundHeart failure (HF) after acute myocardial infarction (AMI) is a leading cause of mortality and morbidity worldwide. Accurate prediction and early identification of HF severity are crucial for initiating preventive measures and optimizing treatment strategies. This study aimed to develop an interpretable artificial intelligence (AI) model for HF severity prediction using multidimensional clinical data.MethodsThis study included data from 1574 AMI patients, including medical history, clinical features, physiological parameters, laboratory test, coronary angiography and echocardiography results. Both deep learning (TabNet, Multi-Layer Perceptron) and machine learning (Random Forest, XGboost) models were employed in constructing model. Additionally, the Shapley Additive Explanation (SHAP) method was used to elucidate clinical factors importance and enhance model interpretability. A web platform (https://prediction-killip-gby.streamlit.app/) was also developed to facilitate clinical application.ResultsAmong the models, TabNet demonstrated the best performance, achieving an AUROC of 0.827 for KILLIP four-class classification and 0.831 for KILLIP binary classification. Key clinical factors such as GRACE score, NT-pro BNP, and TIMI score were highly correlated with KILLIP classification, aligning with established clinical knowledge.ConclusionsBy leveraging easily accessible multidimensional data, this model enables accurate early prediction and personalized diagnosis of HF risk and severity following AMI. It supports early clinical intervention and improves patient outcomes, offering significant clinical application value.Clinical trial numberNot applicable.