Stratification risk score of cardiovascular events in patients with myocardial infarction in combination with comorbid and surgical pathology
DOI:
https://doi.org/10.11603/2414-4533.2019.1.9922Keywords:
myocardial infarction, surgical pathology, risk of cardiovascular events, GRACE score, Charlson comorbidity indexAbstract
The aim of the work: to study the features of physical and biochemical parameters response of the functional state of the body in patients with myocardial infarction (MI) in combination with comorbid pathology (CP), to identify the relationship between marker and limited parameters of the functional state of the body and the risk of cardiovascular events.
Materials and Methods. 371 patients with myocardial infarction with comorbid pathology were investigated, who were consistently included in the prospective study. The basic functional indicators of the body of a patient with MI with CP, as well as their interrelations with the main risk score, clinical markers of physical activity tolerance and Charlson comorbidity index (CCI) were studied.
Results and Discussion. Risk rates on the GRACE score in patients with MI with CP have a direct correlation (point biserial correlation) with indicators of age (r = 0.267; P <0.0001), heart rate (r =0.159; P =0.028), respiratory rate (r =0.248; P =0.001), glucose levels (r = 0.197; =0.007), creatinine (r =0.154; P =0.033) and Charlson Comorbidity Index (r = 0,275; P <0,0001). The inverse correlation was observed between the levels of risk on the GRACE score and hemoglobin levels (r =-0.159; P =0.03), total cholesterol (r = -0.217; P =0.003), LDL (r = -0.292; P <0.0001 ), SpO2 (r = -0.178; P = 0.017), the number of lymphocytes (r =-0.169; P =0.02). An inverse correlation was observed between the level of comorbidity according to CCI and the six-minute walk test on the 10th, 30th and 90th day after the onset of MI development (r10 = -0.318; r30 = -0.397; r90 = -0.425; P <0.0001).
The analysis of specificity and sensitivity of the six-minute walk test on the 10th, 30th and 90th day of rehabilitation of post-infarction patients with CCI values > 2, showed the maximum specificity (1.0) and the predictive value of the positive result (1.0) of this marker in the comorbid patients for 6MWT10 = 83.5-98 m (95% confidence interval (0.672-0.828), P = 0.037); 6MWT30 = 147-166.5 m (95 % confidence interval (0.766-0.904), P = 0.005 and 6MWT90 = 199.5-227.5 m (95 % confidence interval (0.741-0.933), P = 0.005).
References
World Health Organization: WHO. Retrieved from: https://www.who.int/ru/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds).
Mozaffarian, D., Benjamin, E.J., Go, A.S., Arnett, D.K., Blaha, M.J., & Cushman, M. (2016). Heart disease and stroke statistics–2016 update: a report from the American Heart Association. Circulation, 133 (4), e38-e360.
Townsend, N., Nichols, M. Scarborough, P. & Rayner, M. (2015). Cardiovascular disease in Europe – epidemiological update 2015. Eur. Heart J., 36, 2696-2705.
Moroz, D.M. (2016). Problems of health and medical care and a model of improvement in modern conditions: a manual for cardiologists, rheumatologists, therapists, health organizers and general practitioners. Kovalenko, V.M., & Kornatsky, V.M. (Eds.). Institute of Cardiology of M. D. Strazhesko of the AMS of Ukraine. Kyiv: Hordon Printing House.
Barnett, K., Mercer, S.W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012). Epidemiology of multimorbidity and implications for health care, research, and medical education : a cross-sectional study. Lancet, 380 (9836), 37-43. PMID:22579043
Rashid, M., Kwok, C.S., Gale, C.P., Doherty, P., Olier, I., & Sperrin, M. (2017). Impact of co-morbid burden on mortality in patients with coronary heart disease, heart failure and cerebrovascular accident: a systematic review and meta-analysis. Eur. Heart J. Qual Care Clin. Outcomes, 3 (1), 20-36. PMID:28927187
Liashok, A.L. (2013). Peredoperatsiina pidhotovka khvorykh z vysokym kardialnym ryzykom [Preoperative preparation of patients with high cardial risk]. Medytsyna transportu Ukrainy – Transport Medicine of Ukraine, 2, 84-89. Retrieved from: http://www.vitapol.com.ua/user_files/pdfs/mtu/mtu46i14imtui2i2013.pdf [in Ukrainian].
Danilovic, A., Ferreira, T.A.C., Maia, G.V.A., Torricelli, F.C.M., Mazzucchi, E., Nahas, W.C., & Srougi, M. (2018). Predictors of surgical complications of nephrectomy for urolithiasis. Int. Braz. J. Urol., 30, 44. doi: 10.1590/S1677-5538.IBJU.2018.0246. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/30521174
Antonelli, G., Berardi, G., Rampioni Vinciguerra, G.L., Brescia, A., Ruggeri, M., Mercantini, P., … & Giulio, E. (2018). Clinical management of endoscopically resected pT1 colorectal cancer. Endosc. Int. Open, 6 (12), E1462-E1469. doi: 10.1055/a-0781-2293. Epub 2018 Dec 12.
Ibanez, B., James, S., Agewall, S., Antunes, M.J., Bucciarelli-Ducci, C., Bueno, H., … & Goudevenos, J.A. (2018). 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European Heart Journal, 39, 2, 119-177. Retrieved from: https://doi.org/10.1093/eurheartj/ehx393
Roffi, M., Patrono, C., Collet, J.-Ph., Mueller, Ch., Valgimigli, M., Andreotti, F., … & Chew, D.P. (2016). 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). European Heart Journal, 37, 3, 267-315. Retrieved from: https://doi.org/10.1093/eurheartj/ehv320
Thygesen, K., Alpert, J.S., Jaffe, A.S., Chaitman, B.R., Bax, J.J., Morrow, D.A., & White, H.D. (2018). Fourth universal definition of myocardial infarction. European Heart Journal, 40, 3, 237-269. Retrieved from: https://doi.org/10.1093/eurheartj/ehy462
Charlson, M.E., Pompei, P., & Ales, H.L. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal Chronic Disease, 40, 373-383.
Shved, M.I., & Levytska, L.V. (2018). Suchasni tekhnolohii vidnovnoho likuvannia khvorykh iz hostrym koronarnym syndromom [Modern technologies of restorative treatment of patients with acute coronary syndrome]. Kyiv: Vydavnychyi dim Medknyha [in Ukrainian].
Shved, M.I., & Levytska, L.V. (2018). Pidkhody do otsinky ryzykiv ta funktsionalnykh rezerviv sertsevo-sudynnoi systemy u khvorykh na infarkt miokarda z komorbidnoiu patolohiieiu, yaki perebuvaiut u hostromu periodi kardioreabilitatsii [Approaches to the assessment of the risks and functional reserves of the cardiovascular system in patients with myocardial infarction with comorbid pathology, who are in the acute period of cardio-rehabilitation]. Svit medytsyny ta biolohii – World of Medicine and Biology, 4 (66), 124-130 [in Ukrainian].
Bellet, R.N., Francis, R., Jacob, J.S., Healy, K.M., Bartlett, H.J., Adams, H.J., & Morris, M. (2011). Repeated six-minute walk tests for outcome measurement and exercise prescription in outpatient cardiac rehabilitation: a longitudinal study. Arch. Phys. Med. Rehabil., 92 (9), 1388-1394
Pett, M.A. (1997). Nonparametric statistics for health care research : Statistics for small samples and unusual distributions. Thousand Oaks, CA: Sage Publications.
Levytska, L.V. (2018). Medyko-sotsialni aspekty vidnovnoho likuvannia khvorykh na infarkt miokarda z komorbidnym tsukrovym diabetom [Medico-social aspects of restorative treatment of patients with myocardial infarction with comorbid diabetes mellitus]. Visnyk sotsialnoi hihiieny ta orhanizatsii okhorony zdorovia Ukrainy – Bulletin of Social Hygiene and Health Care Organizations of Ukraine, 4 [in Ukrainian].
Melnyk, V.M., Poida, O.I., & Abdul Kadir, A. (2018). Surgical rehabilitation of patients with atypical anatomical and functional states after radical organ-preserving operations for non-tumour colon diseases. Shpytalna khirurhiia. Zhurnal imeni L.Ya Kovalchuka –Hospital Surgery. Journal named after L.Ya. Kovalchuk, 3, 38-43.
Hrebenyk, M.V., Liuta, O.T., Mykuliak, V.R. (2014). Otsinka indeksu komorbidnosti u khvorykh na hostryi infarkt miokarda [Estimation of the comorbidity index in patients with acute myocardial infarction]. Visnyk naukovykh doslidzhen – Bulletin of Scientific Researches, 2, 14-15. Retrieved from: http://nbuv.gov.ua/UJRN/vndt_2014_2_6 [in Ukrainian].
St-Louis, E., Iqbal, S., Feldman, L., Sudarshan, M., Deckelbaum, D., Razek, T., & Khwaja, K. (2015). Using the age-adjusted Charlson comorbidity index to predict outcomes in emergency general surgery. Journal of Trauma and Acute Care Surgery, 78 (2), 318-323. DOI: 10.1097/TA.0000000000000457
Piatnochka, V.I. (2018). Vplyv komorbidnosti na rezultaty khirurhichnoho likuvannia khvorykh iz pervynnymy ta intsyziinymy ventralnymy hryzhamy [The influence of comorbidity on the results of surgical treatment of patients with primary and incident ventral hernias]. Shpytalna khirurhiia. Zhurnal imeni L.Ya. Kovalchuka – Hospital surgery. Journal named after L.Ya. Kovalchuk, 1, 10-15. DOI 10.11603/2414-4533.2018.1.8859 [in Ukrainain].
Khene, Z.E., Peyronnet, B., Freton, L., Graffeille, V., Pradere, B., Robert, C., & Bensalah, K. (2018). What Is Better for Predicting Morbidity of Robotic Partial Nephrectomy-A Score or Your Clinical Judgement? Eur. Urol. Focus, 12. doi: 10.1016/j.euf.2018.10.016. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/30442584
Parkhomenko, A.N., Irkin, O.I., & Lutay, Ya.M. (2012). Predoperatsionnaya stratifikatsiya riska oslozhneniy [Preoperative risk stratification of complications]. Meditsina neotlozhnykh sostoyaniy – Emergency Medicine, 4, 26-31 [in Russian].
Shved, M., Tsuglevych, L., Kyrychok, I., Levytska, L., Boiko, T., & Kitsak, Y. (2017). Cardio-rehabilitation peculiarities and correction of violations of systolic, diastolic function and heart rate variability in patients with acute coronary syndrome and coronary artery revascularization. Georgian Medical News, 265, 46-53.
Hall, M., Dondo, T.B., Yan, A.T., Mamas, M.A., Timmis, A.D., Deanfield, J.E., … & Gale, C.P. (2018). Multimorbidity and survival for patients with acute myocardial infarction in England and Wales : Latent class analysis of a nationwide population-based cohort. PLoS Med., 6, 15 (3), e1002501. doi: 10.1371/journal.pmed.1002501.
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