Abstract
The aim is to develop a method for predicting the course of heart failure (HF) in patients with coronary heart disease (CHD) in combination with type 2 diabetes mellitus (DM). The study included 100 men aged 50 to 67 years with CHD in combination with type 2 DM. Patients were divided into two groups depending on the course of HF: I (n = 66) — with a favorable course, II (n = 34) — with an unfavorable course (decreased LV EF, patients with impaired diastolic function, and those who died during the year of observation). Analysis of cardiovascular anamnesis and indicators of carbohydrate and lipid metabolism were conducted; a transthoracic echocardiography was performed; endothelium-dependent dilation of the brachial artery (EDD) was studied. The Mann-Whitney U-test was used to determine the differences between independent samples, and the logistic regression method was used for prognosis. On the basis of the conducted research, a method for determining the prognosis of HF during a year in patients with coronary heart disease in combination with type 2 DM is proposed, by which, through additional research and determination of clinical and laboratory features with subsequent calculation, the prediction is achieved. For prognosis and subsequent calculation the formula using coefficients for prognostic factors, it is necessary to study EDD, arterial blood pressure with a calculation of pulse pressure, determine serum insulin with the calculation of the HOMA index, and use the regression equation with a high level of sensitivity and specificity to determine the probability of an adverse course of HF in patients with preserved ejection fraction.
Highlights
The risk of cardiovascular complications in patients with type 2 diabetes mellitus (DM) is 2–3 times higher than the average in the population, and the long-term prognosis is worse in patients with coronary heart disease (CHD)
There were no significant differences in hereditary predisposition to CHD in groups with different variants of the course of HF (p > 0.05), and there were no significant differences in body/ mass index (BMI) (p > 0.05)
Comparing the values of lipid metabolism in patients with an unfavorable course, statistically significant higher values were found for the level of total cholesterol (TC) (p < 0.001), low density lipoprotein (LDL) (p < 0.001), and the atherogenic index (AI) (p < 0.001)
Summary
An examination of 100 male patients with CHF of ischemic genesis and CHD in combination with type 2 DM was performed. Glycosylated hemoglobin (HbA1c) was determined in blood serum by Turbidimetric method using the Liquidirect kit (Human GmbH, Germany). The insulin resistance index (HOMA) was calculated by the formula: HOMA = = serum insulin level × glucose level / 22.5. The binary logistic regression analysis was used to determine the predictors of the mathematical model according to the analysis of 62 indicators [10]. This method investigated the dependence of dichotomous variable on the independent, which have any kind of scale, and the probability of an event depending on the values of the independent variables was calculated by the formula:.
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