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Inventory reference ISSN 1812-7231 Klin.inform.telemed. Volume 14, Issue 15, 2019, Pages 58-66

Author(s) A. V. Lyashenko, L. H. Voronkov, P. N. Babych


National Scientific Center "Institute of Cardiology named after Acad. N. D. Strazhesko "NAMS of Ukraine", Kiev

Article title Prediction of a combined critical event in patients with chronic heart failure and reduced left ventricular ejection fraction for long observation.

Abstract (resume)

Aim. To make a mathematical model of individual combined endpoint (death or HF hospitalization) in patients with chronic heart failure and reduced left ventricular ejection fraction on the basis of the invented survival predictors in this cohorts of patients.

Materials and methods. 134 patients with ischemic CHF (NYHA II-ІV) and LVEF < 40% were examined. The assessment of the influence of clinical and demographic and other parameters on the combined endpoint of patients was performed by F Mantel-Cox test and SPSS 13.0. The structure of the regression equation was formed using the algorithm of sequential stepwise input of explanatory variables (covariates) and their interactions. As a method of step-by-step input, the method "Forward Stepwise (Conditional LR)" was used ("Gradual inference using conditional believability").

Research results. Plasma levels of bilirubin and citrullin as well as BMI and MHFLQ score are the strong predictors of critical event (death or HF hospitalization) in CHF with redLVEF. The obtained model for predicting of critical event in patients with CHF and reduced LVEF is informative (statistics -2 LogLikelihood is equal 142,699) and adequately describes the risk depending on the variables. The regression equation includes the following changes, and their respective coefficients: FMVR < 8,775%, BMI < 28,73 kg/m2, MHFLQ score > 40,5, creatinine > 90 mkmol/l, bilirubin < 42,5 mkmol/l. The model is characterized by the following indicators: sensitivity 76,9%, specificity 72,9%, accuracy 75%.

Conclusion. The obtained results open the perspectives of optimization of medical-diagnostic measures in patients with heart failure. Individual prognosis of CHF can be used for timely formation of the corresponding groups and their active ambulatory care.

Keywords Heart failure, Critical event, Predictors, Mathematical model


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