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

DOI: https://doi.org/10.29296/25877305-2020-10-07
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Issue: 
10
Year: 
2020

E. Shishkina(1), Candidate of Medical Sciences; Professor A. Agafonov(1), MD; Professor O.
Khlynova(1), MD, Corresponding Member of the Russian Academy of Sciences; Professor L. Vasilets(1), MD; G.
Spasenkov(2) (1)Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia (2)Clinical
Cardiology Dispensary, Perm

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.
Keywords: 
cardiology
myocardial infarction
working age
post-hospital mortality
risk assessment
multifactorial prediction
platelet-to-lymphocytic ratio

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