Predictive model for the risk of complications in patients with acute myocardial infarction
Keywords:
complications, echocardiography, myocardial infarctionAbstract
Introduction: Cardiovascular diseases are one of the most important medical-health problems in contemporary medicine; they are the leading cause of death worldwide and among them, ischemic heart disease causes the highest number of deaths and years of life lost. They are largely associated with cardiac complications in the acute phase of the coronary event.
Objective: To design a clinical-echocardiographic predictive model of cardiac complications in patients with acute myocardial infarction.
Methods: Retrospective case-control research, carried out at the Santiago de Cuba Cardiovascular Surgery and Cardiology Center, during the period from 2019 to 2021. Clinical and echocardiographic variables were analyzed. A multivariate analysis and model validation parameters were performed.
Results: Cardiac complications were associated with age ≥ 65 years (odd ratio-OR= 12.28; 95% CI: 8.16-18.49; p= 0.001), absence of thrombolytic therapy (OR= 1.63; 95% CI: 1.18-2.26; p= 0.001), and left ventricular systolic function (OR= 1.76; 95% CI: 1.23-2.52; p= 0.001). The area under the curve (AUC) ranged from 0.875 to 0.926. The model fit was Nagelkerke's R2, whose value of 0.65 explains about 66% of cardiac complications; the corresponding statistic of the Hosmer-Lemeshow test had a value of 0.760.
Conclusions: The predictive model designed from clinical and echocardiographic elements presented good fit and discriminatory power, especially positive predictive value.
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References
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