Long Term Outcome Prediction in Stemi/Nstemi Patients By Means of the Model Consisting of Simple Clinical Parameters

Paweł Korczyc, J. Chrzanowski, A. Stasiak, J. Stasiak, A. Bissinger, Wojciech Timler, D. Timler, G. Piotrowski
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Abstract

Aim: Our study aimed to identify the clinical variables associated with long-term mortality after MI and to construct a simple, easy to use clinical practice model for the prediction of 5 year mortality after MI. Material and Methods: This is a prospective 5-year observation study of MI patients admitted to the Department of Cardiology at the Copernicus Memorial Hospital in Lodz in 2010 and 2011. The data were collected during hospitalization and again after a period of 1 and 5 years. A multi-factor multi-level Cox regression model was constructed to investigate the impact of clinical factors on long-term survival.results: 92 patients (39 STEMI, 53 NSTEMI) were included in the study and their data were used to construct a Cox regression model with satisfactory fit (R 2 =0.7945). Factors associated with a decrease in 5-year risk are: age (1.06, 95%CI: 1.01-1.11), SYNTAX score (1.05, 95%CI: 1.02-1.08), WBC level (1.16, 95%CI: 1.08-1.26), and glycemia at enrollment (1.01, 95%CI: 1.01-1.01). Higher values of HDL at enrollment were associated with a decrease in 5-year risk (HR=0.97, 95%CI: 0.93-0.99).conclusion: The model we created is a valuable tool that is useful and easy to employ in everyday practice for assessing the 5-year prognosis of patients after MI. What is new: The study presents the new model for prediction of 5-year mortality after myocardial infarction. This model is based on simple clinical parameters and may by applied in everyday practice.
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基于简单临床参数模型的Stemi/Nstemi患者远期预后预测
目的:我们的研究旨在确定与心肌梗死远期死亡率相关的临床变量,并构建一个简单易用的临床实践模型来预测心肌梗死后5年死亡率。材料与方法:本研究对2010年和2011年在Lodz哥白尼纪念医院心内科住院的心肌梗死患者进行了为期5年的前瞻性观察研究。数据在住院期间收集,并在1年和5年后再次收集。建立多因素多级Cox回归模型,探讨临床因素对长期生存的影响。结果:92例患者(STEMI 39例,NSTEMI 53例)纳入研究,采用数据构建拟合满意的Cox回归模型(r2 =0.7945)。与5年风险降低相关的因素有:年龄(1.06,95%CI: 1.01-1.11)、SYNTAX评分(1.05,95%CI: 1.02-1.08)、WBC水平(1.16,95%CI: 1.08-1.26)和入组时血糖(1.01,95%CI: 1.01-1.01)。入组时较高的HDL值与5年风险降低相关(HR=0.97, 95%CI: 0.93-0.99)。结论:所建立的模型是评估心肌梗死患者5年预后的一种有价值的工具,在日常实践中具有实用性和可操作性。创新点:本研究提出了预测心肌梗死后5年死亡率的新模型。该模型基于简单的临床参数,可应用于日常实践。
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