Method for predicting atherosclerotic lesion of coronary vessels in women of premenopausal age at clinics of ischemic cardiac disease

FIELD: medicine, cardiology.

SUBSTANCE: one should carry out discriminant analysis to create discriminant function with coefficients of independent variables, such as: arterial hypertension, anemia, gynecological disease, hyperglycemia, cholelithiasis, smoking, lipid disorders, pathological menopause, excessive body weight and thyroid diseases. It is necessary to evaluate every risk factor and solve the function. At the value of function being above 1.710 one should predict the absence of atherosclerotic lesion of coronary vessels. The innovation enables to establish the probability of atherosclerotic lesion of coronary vessels or its absence according to risk factors in female patients due to carrying out discriminant analysis.

EFFECT: higher accuracy of prediction.

3 ex

 

The invention relates to medicine, particularly cardiology, and can be used to predict the status of coronary artery disease in women premenopausal age with clinical coronary heart disease.

It is known that coronary heart disease (CHD) in women develops in 10-15 years later than men, due to the protective action of sex hormones. Therefore, the development and course of coronary artery disease in women in premenopausal age is different etiological and pathogenetic mechanisms. For example, the fact that clinical manifestations of coronary artery disease in women of this age are often not confirmed by atherosclerotic changes in the coronary arteries when koronaroangiografii (CAG). The percentage of unmodified and maloizmenennykh coronary arteries in women under 55 years of age with clinical CHD according to CAG reaches 25%-52%. A result of which the practitioner arise diagnostic difficulties and complications with the treatment of such patients.

Closest to the technical nature of the achieved effect and selected as a prototype is a method of assessment of risk factors for the development of atherosclerotic lesions in women with ischemic heart disease, where the marker of the development of premature coronary heart disease is hemorheological measures of the degree of viscosity of the blood (hematocrit): De Backer TL, De Buyzre M, Segers P, et al. // The role of whole blood viscosity in premature coronary artery disease in women. // Atherosclerosis. 2002 Dec; 165(2):367-73. In this prototype with the help of mathematical methods (regression analysis) predicted cardiovascular risk in women with premature coronary heart disease.

The present invention is the prediction of atherosclerotic lesions of the coronary arteries in women under 55 years of age with premature coronary heart disease using a mathematical method of discriminant analysis.

The technical result of the invention is to establish the likelihood of atherosclerotic lesions of the coronary vessels or lack thereof according to the patient's risk factors by conducting a discriminant analysis.

This problem is solved due to the fact that in the method for predicting atherosclerotic lesions of coronary arteries in women premenopausal age with clinical coronary heart disease using a mathematical method according to the invention is conducted discriminant analysis and constitute the discriminant function

D=-2,494+1,097*AG-0,62*AH+1,777*GIN-0,242*GLICK+1,872*GKB-0,541*CHICKEN+0,17*LN-2,889*MYUNG-0,953*BMI+1,506*STRESS+1,011*thyroid

with the coefficients of the independent variables, which are the following risk factors: hypertension - hypertension, anti - anemia, GIN - gynecologists the definition of the disease, GLICK - hyperglycemia, JCB - cholelithiasis, CSD - Smoking, LN - lipid disorders, MYUNG - pathological menopause, BMI - overweight, Stress, thyroid - thyroid disease; assess each risk factor for gradation: "Yes" corresponds to 1, "no" corresponds to 2; and decide if the value -1,368 predict the presence of atherosclerotic lesions of the coronary vessels, and a value of +1,710 - no defeat.

Therefore, the listed set of risk factors may be a predictor of atherosclerotic changes or lack thereof in women premenopausal age with clinical CHD and used in clinical practice physician for diagnostic purposes. Thus, the inventive method is available, and therefore, "actionable".

Example: the Patient K., 50 years old, was admitted to the hospital with a diagnosis of coronary artery disease: Unstable angina. Of the risk factors has hypertension and obesity, other risk factors netdocuments function in this patient will have the following meanings:

IN=-2,494+1,097*1(AG)OF-0.62*2(EN)+1,777*2(GIN)-0,242*2(GLICK)+1,872*2 (GCB) -0,541*2 (CSD) +0,17*2 (LN) -2,889*2 (MEN) -0,953*1 (BMI) +1,506*2 (STRESS) +1,011*2 (THYROID) =-2,494+1,097-1,24+3,554-0,484+3,744-1,082+0,34-5,778-,953+3,012+2,022=+1,738

On the obtained value of the discriminant function, is equal to +1,738, with high precision to predict in this patient, izmenenie coronary vessels.

Conducted forecasting the state of the coronary vessels using discriminant equation 34 women with premature coronary heart disease. As the independent variables of this equation were the risk factors (hypertension, BMI, EN, GIN, GLICK, thyroid, Stress, JCB, LN, CHICKENS, MAINE). The obtained value of the discriminant functions was possible to perform the separation of patients in groups: a group of individuals with atherosclerosis of the coronary vessels and the group of persons with intact coronary arteries. The results obtained using discriminant equations were compared with the data of koronaroangiografii. Of the 34 cases data koronaroangiografii using discriminant functions correctly classified 27 (79.4 per cent), of which 12 cases of coronary atherosclerosis and 15 cases of unmodified coronary vessels. The sensitivity of the proposed method was 0,79.

Clinical examples:

Example: the Patient B., 55 years old, was admitted to the hospital with a diagnosis of coronary artery disease: Acute myocardial infarction. Risk factor is hypertension, gallstone disease, lipid disorders, excess body weight and pathology of the thyroid gland. Discriminant function in this patient will have the following meanings:

D=-2,494+1,097*AG-0,62*AN+1,777*GIN-0,242*GLYC+1,872*GKB-0,541*CUR+0,17*LN-2,889*MEN-0,953*IMT+1,506*STRESS+1,011*SI=-2,494+1,097-1,24+3,554-0,484+1,872-1,082+0,17-5,778-0,9533,012+1,011=-1,368

On the obtained value of the discriminant function, is equal to (-1,368), we can predict from this patient, atherosclerosis of coronary vessels.

Example: the Patient K., 50 years old, was admitted with a diagnosis of ischemic heart disease: Angina. Of the risk factors has hypertension and obesity. Discriminant function in this patient will have the following meanings:

D=-2,494+1,097*AG-0,62*AN+1,777*GIN-0,242*GLYC+1,872*2 GKB-0,541*2 CHICKENS+0,17*2 LN-2,889*2 MYUNG-0,953*1 BMI+1,506*2 STRESS+1,011*2 thyroid=-2,494+1,097-1,24+3,554-0,484+3,744-1,082+0,34-5,778-0,953+3,012+2,022=+1,738

On the obtained value of the discriminant function, is equal to (+1,710), we can predict from this patient, unmodified coronary vessels.

A method for predicting the absence of atherosclerotic lesions of the coronary arteries in women premenopausal age with clinical coronary heart disease using a mathematical method, characterized in that conduct discriminant analysis and constitute the discriminant function:

D=-2,494+1,097·AG-0,62·EN+1,777·GIN-0,242·GLICK+1,872·JCB-0,541·CHICKENS+0,17·LN-2,889·MYUNG-0,953·BMI+1,506·STRESS+1,011·thyroid

with the coefficients of the independent variables, which are the following risk factors: hypertension - hypertension, anti - anemia, GIN - gynecological diseases, GLICK - hyperglycemia, JCB - cholelithiasis, LAYING uranie, LN - lipid disorders, MYUNG - pathological menopause, BMI - overweight, stress, thyroid - thyroid disease; assess each risk factor for gradation - "YES" corresponds to 1, "NO" corresponds to 2; and decide if the value is greater than 1,710 predict the absence of atherosclerotic lesions of the coronary vessels.



 

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