A prediction model for coronary artery diseases in elder patients undergoing operations for rheumatic heart valve disease: establishment and assessment

Abstract

Objective To screen the risk factors for coronary artery diseases(CAD) before undergoing operation for rheumatic heart valve disease(RHVD) in elder patients and to establish a logistic model for predicting CAD,so as to guide the selection of coronary angiography.Methods A total of 585 elder patients who underwent routine coronary angiography before heart valve operations for RHVD during 1998-2009 were analyzed in the present study.Logistic regression was employed to screen the risk factors for CAD and to establish a bootstrap logistic regression model,with P0.05 used for identifying the low-risk patients.The receiver operating characteristic(ROC) curves were used to compare the diagnosis efficacies of the established model and other similar models.Results It was found that the independent predictors of CAD in elder RHVD patients included age,male sex,angina,hypertension,and hypercholesterolemia.A predicting logistic model was successfully established.According to the model,155 patients were designated as low risk,with 4(2.6%) complicated with single-vessel disease CAD.The model showed better discrimination efficacy compared with the existing ones,with the area under the ROC curve being 0.793.Conclusion We have successfully established a predicting model for CAD in elder patients undergoing operation for RHVD,which may help to screen CAD in elder patients before receiving heart valve operations for RHVD.