Possibilities for predicting post-hospital mortality in able-bodied patients with non-Sr segment elevation myocardial infarction


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With the available variety of prognostic factors that influence long-term adverse outcomes in patients with myocardial infarction (MI), their role in death in a cohort of able-bodied patients remains controversial. Objective: to determine the predictors of poor long-term prognosis of non-ST segment elevation MI (NSTEMI) in able-bodied patients and, on the basis of the findings, to propose a mortality prediction model for this patient category. Subjects and methods. The investigation enrolled 155 patients (139 men and 16 women; mean age, 51 [44; 55] years) with an established diagnosis of NSTEMI. Twelve months after the onset of MI, their vital status was determined by analyzing data from electronic medical records of patients. Univariate and multivariate regression analyses were performed to determine the independent predictors of mortality. Results and discussion. Multivariate regression analysis could establish that left ventricular ejection fraction <50% (p=0.045) and platelet-to-lymphocyte ratio >122 (p=0.028) were statistically significantly associated with mortality in able-bodied patients with NSTEMI. The area under the ROC curve for the resulting risk model was 0.85; the sensitivity and specificity were 71.4% and 96.2%, respectively. Conclusion. The investigation has yielded an original post-hospital mortality prediction model using routine clinical parameters in able-bodied patients with NSTEMI. To stratify patients who are at a high risk of death, it may be necessary to take into account the left ventricular ejection fraction and the value of a platelet-to-lymphocyte ratio.

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作者简介

E. Shishkina

Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia

Email: doctor.shishkina@yandex.ru

A. Agafonov

Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia

O. Khlynova

Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia

L. Vasilets

Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia

G. Spasenkov

Clinical Cardiology Dispensary, Perm

参考

  1. Бойцов С. А., Демкина А. Е., Ощепкова Е. В. и др. Достижения и проблемы практической кардиологии в России на современном этапе. Кардиология. 2019; 59 (3): 53-9 DOI: 10.18087/ cardio.2019.3.10242
  2. Драпкина О.М., Самородская И.В., Старинская М.А. и др. Сравнение российских регионов по уровню стандартизованных коэффициентов смертности от всех причин и болезней системы кровообращения в 20062016 гг. Профилактическая медицина. 2018; 21 (4): 4-12 DOI: 10.17116/ profmed20182144
  3. Концевая А.В., Драпкина О.М., Баланова Ю.А. и др. Экономический ущерб сердечно-сосудистых заболеваний в Российской Федерации в 2016 году. Рациональная фармакотерапия в кардиологии. 2018; 14 (2): 156-66 doi: 10.20996/1819-6446-2018-142-156-166
  4. Fox K.A., Dabbous O.H., Goldberg R.J. et al. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE). BMJ. 2006; 333 (7578): 1091. doi: 10.1136/bmj.38985.646481.55
  5. Huang D., Cheng Ya, Wong Yi et al. Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention of Recurrent Cardiovascular Events in a Real-World Cohort of Post-Acute Myocardial Infarction Patients. Circ J. 2019; 83 (4): 809-17. doi: 10.1253/circj.CJ-18-0308
  6. Zhou D., Wan Z., Fan Y. et al. A combination of the neutrophil-to-lymphocyte ratio and the GRACE risk score better predicts PCI outcomes in Chinese Han patients with acute coronary syndrome. Anatol J. Cardiol. 2015; 15 (12): 995-1001. doi: 10.5152/AnatolJCardiol.2015.6174
  7. Qijek G., Ajikgoz M., Bozbay S. et al. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio combination can predict prognosis in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Angiology. 2015; 66 (5): 441-7. doi: 10.1177/0003319714535970
  8. Cho K.I., Ann S.H., Singh G.B. et al. Combined Usefulness of the Platelet-to-Lymphocyte Ratio and the Neutrophil-to-Lymphocyte Ratio in Predicting the LongTerm Adverse Events in Patients Who Have Undergone Percutaneous Coronary Intervention with a Drug-Eluting Stent. PLoS One. 2015; 10 (7): e0133934. doi: 10.1371/journal.pone.0133934
  9. Plakht Y., Shiyovich A., Gilutz H. Predictors of long-term (10-year) mortality postmyocardial infarction: age-related differences. Soroka Acute Myocardial Infarction (SAMI) Project. J. Cardiol. 2015; 65 (3): 216-23. DOI: 10.1016/j. jjcc.2014.06.001
  10. Shah N., Kelly A.M., Cox N. Myocardial Infarction in the «Young»: Risk Factors, Presentation, Management and Prognosis. Heart, Lung and Circulation. 2016; 25 (10): 955-60. doi: 10.1016/j.hlc.2016.04.015
  11. Singh B., Goyal A., Chhabra S. et al. The prevalence, clinical spectrum and the long term outcome of ST-segment elevation myocardial infarction in young - a prospective observational study. Cardiovasc Revasc Med. 2019; 20 (5): 387-91. doi: 10.1016/j.carrev.2018.07.020
  12. Thygesen K., Alpert J., Jaffe A. et al. Fourth Universal Definition of Myocardial Infarction (2018). J. Am Coll Cardiol. 2018; 72 (18): 2231-64. doi: 10.1016/j.jacc.2018.08.1038
  13. Feldman L., Steg P., Amsallem M. et al. Editor’s Choice-Medically managed patients with non-STelevation acute myocardial infarction have heterogeneous outcomes, based on performance of angiography and extent of coronary artery disease. Eur Heart J. Acute Cardiovasc Care. 2017; 6 (3): 262-71. doi: 10.1177/2048872615626354
  14. Fox K., Carruthers K., Dunbar D. et al. Underestimated and underrecognized: the late consequences of acute coronary syndrome (GRACE UK-Belgian Study). Eur Heart J. 2010; 31 (22): 2755-64. doi: 10.1093/eurheartj/ehq326
  15. Eagle K., Lim M., Dabbous O. et al. A validated prediction model for all forms of acute coronary syndrome: estimating the risk of 6-month postdischarge death in an international registry. JAMA. 2004; 291 (22): 2727-33. DOI: 10.1001/ jama.291.22.2727
  16. Эрлих А.Д. Новая шкала прогнозирования смертельных исходов через 6 месяцев после острого коронарного синдрома. Российский кардиологический журнал. 2020; 25 (2): 3416 doi: 10.15829/1560-4071-2020-2-3416
  17. Li W., Liu Q., Tang Y. Platelet to lymphocyte ratio in the prediction of adverse outcomes after acute coronary syndrome: a meta-analysis. SciRep. 2017; 10 (7): 40426. doi: 10.1038/srep40426

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