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Type of publication: research article
Type of publication (PDB): Straipsnis Clarivate Analytics Web of Science / Article in Clarivate Analytics Web of Science (S1)
Field of Science: Medicina / Medicine (M001)
Author(s): Urbonavičienė, Gražina;Urbonavičius, Sigitas;Vorum, Henrik;Blužaitė, Ina;Jaruševičius, Gediminas;Honore, Bent;Tamošiūnaitė, Minija
Title: Evaluation of prognostic clinical and ECG parameters in patients after Myocardial infarction by applying logistic regression method
Is part of: Pacing and clinical electrophysiology (PACE). Oxford : Blackwell Publishing Ltd, 2008, Vol. 31, iss. 11
Extent: p. 1391-1398
Date: 2008
Keywords: Heart rate variability;Myocardial infarction;QT interval;Risk stratification;Signal-averaged ECG
Abstract: Noninvasive risk stratification of patients who have suffered myocardial infarction (MI) is one of the greatest challenges in today's cardiology. No single test has sufficient predictive ability. Therefore, a combination of the tests must be applied for better post-MI risk stratification. The purpose of this study was to assess noninvasive predictors of 2 years cardiac mortality in post-MI patients and create a stratification model for identification of high-risk patients. Clinical, electrocardiographic, and echocardiographic parameters were evaluated before hospital discharge in 180 survivors of acute MI (mean age 57.0 ± 9.9, male 82.2%), followed up for 2 years. A multivariate logistic regression analysis was used to determine informative predictors of cardiac mortality. A clinical score was constructed using the regression coefficient from the multivariate model. During follow-up, 16 deaths (8.8%) occurred. Multivariate analysis identified a combination of six variables that showed the strongest association with cardiac mortality. Based on the coefficients of the logistic regression, six variables were used to create a scoring system: filtered QRS duration (QRSd) >114 ms, coefficient of variation (Cv) ≤2.5%, maximal corrected QT interval (QTcmax) ≥445 ms, left ventricular ejection fraction (LVEF) ≤30%, the absence of use of β-blockers (BB), and absence of treatment by primary percutaneous coronary intervention (PCI). The cutoff value for the score of 10 or higher, defined the “high-risk” patients with a sensitivity of 75% and a specificity of 70%. The mortality rate for the low- and high-risk groups were 12.5% and 87.5%, respectively. The receiver operating characteristic (ROC) analysis yielded area under curve of 0.88. The proposed scoring system could be valuable in predicting 2 years risk of cardiac mortality in post-MI population and allows the stratification of patients into low- and high-risk groups
Affiliation(s): Kauno medicinos universiteto Kardiologijos institutas
Vytauto Didžiojo universitetas
Appears in Collections:Universiteto mokslo publikacijos / University Research Publications

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