Aim To analyze the predictive value of plasma ApoB/ApoA ratio and D-dimer (D-D) levels for left ventricular thrombosis (LVT) after PCI in patients with acute ST-segment elevation myocardial infarction (STEMI), and establish a column chart model. Methods 187 STEMI patients admitted to Fuyang Sixth People's Hospital from January 2021 to December 2022 were selected. According to the follow-up results 28 days after surgery, the patients were divided into LVT group and non LVT group. The study conducted univariate and binary Logistic regression analysis on clinical data such as plasma ApoB/ApoA1 ratio and D-D in the two groups of patients, identified independent risk factors for LVT formation in STEMI patients after PCI, established a column chart model, and evaluated the diagnostic efficacy of the column chart model. Results The results showed that an increase in the ApoB/ApoA1 ratio (OR＝1.0,5%CI:1.057～1.648), an increase in D-D levels (OR＝1.1,5%CI:1.020～1.042), a preoperative TIMI of 0 (OR＝4.1,5%CI:1.018～16.849), and a decrease in LVEF (OR＝0.6,5%CI:0.853～0.963) were independent risk factors for LVT formation after PCI (P＜0.05), and the AUC predicted by the above indicators for LVT formation were 0.2,0.0,0.623 and 0.726, respectively. Based on the above indicators, a column chart model was established. ROC curve analysis showed that the consistency index of the model was 0.926, and the calibration curve showed that the model had good discrimination and consistency. Conclusions The increase in plasma ApoB/ApoA1 ratio and D-D levels in STEMI patients is closely related to the formation of LVT after PCI. The column chart model established based on the above indicators has high diagnostic efficacy in predicting LVT, which is beneficial for clinical medical staff to identify high-risk patients.