Abstract
Objective This study aimed to construct a 5-year survival prediction model of coronary heart disease (CHD) induced chronic heart failure (CHF), which is supported by the traditional Chinese medicine (TCM) factor, and to verify the model. Methods Inpatients from January 1, 2012, to December 31, 2017, in seven hospitals in Shandong Province were studied. The random number table was used to randomly divide the seven hospitals into two groups (training set and verification set). In the training set, the least absolute shrinkage selection operator regression was first used to screen the independent variables. Logistic regression was then applied to construct a survival prediction model. The following nomogram visualizes the prediction model results. Finally, C-indices, calibration curves, and decision curves were used to discriminate and calibrate the established model and evaluate its practicability in the clinic. Bootstrap resampling and the verification set were used for internal and external verification, respectively. Results A total of 424 eligible patients were included in the model construction and verification. In this 5-year survival prediction model of patients with CHF induced by CHD, eight independent predictors were included. The series of C-indices for the training set, bootstrap resamples, and verification set was 0.885, 0.867, and 0.835, respectively, demonstrating the credibility of our model. Additionally, the receiver operating characteristic curve, calibration curve, and clinical decision curve analysis of the training and verification sets showed that this 5-year survival prediction model was good in discrimination, calibration, and clinical practicability. Conclusion This work highlights eight independent factors affecting 5-year mortality in patients with CHF induced by CHD after discharge and further helps reallocate medical resources rationally by precisely identifying high-risk groups. The constructed prediction model not only plays a credible role in prediction but also demonstrates TCM intervention as a protective factor for the 5-year death of patients with CHF induced by CHD, thereby advancing the use of TCM in CHF.
Highlights
Heart failure (HF) is a multi-incentive disease characterized by a structural or functional disorder of the myocardium, which results in decreased pumping power or filling function, a common end of most cardiovascular diseases
1321 patients with ejection fraction (EF) ≥ 50% were excluded. erefore, a total of 793 patients with Chronic heart failure (CHF) induced by coronary heart disease (CHD) with EF < 50% were selected. 17 patients had serious outcome events
We first investigated traditional Chinese medicine (TCM) intervention as a factor and successfully developed a 5-year survival prediction model for patients with CHF induced by CHD
Summary
Heart failure (HF) is a multi-incentive disease characterized by a structural or functional disorder of the myocardium, which results in decreased pumping power or filling function, a common end of most cardiovascular diseases. Chronic heart failure (CHF) is persistent HF that can stabilize, worsen, or decompensate. Followed by the prevalence and incidence of patients with CHF exhibit an upward trend [1]. The prevalence of CHF in developed countries is approximately 1−2%, and the annual incidence is approximately 0.5−1%. In China, the prevalence of CHF is about 1.3%. At is, about 13.7 million people suffer from CHF. Evidence-based treatment has reduced the mortality of CHF, the mortality in severe cases still approaches 50%, even worse than the prognosis of the common cancers [2]. Evidence-based treatment has reduced the mortality of CHF, the mortality in severe cases still approaches 50%, even worse than the prognosis of the common cancers [2]. erefore, seeking an effective
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