Medical model of the diagnosis of multifocal atherosclerosis in patients with stable ischemic heart disease

Abstract

Abstract Purpose To build a model according to which it would be possible to predict the presence of multifocal atherosclerosis (MFA) in patients with stable forms of coronary heart disease. Materials and results The study included 102 patients with exertional angina, (62 men (60.8%) and 40 women (39.2%), mean age 64.2±12.7 years. A search was carried out among the parameters of the local register of patients with coronary artery disease (385 items), which had the strongest relationship and influenced the presence of MFA. These turned out to be: chronic obstructive pulmonary disease (r=0.270 at p=0.006, F-criterion 5.169 at p=0.07), chronic kidney disease (r=0.330 at p=0.001, F-criterion 12.203 at p=0.001), level of the coefficient of variation of erythrocytes (RDW-CV) (r=0.228 at p=0.004, F-criterion 2.022 at p=0.015), leukocyte count (r=0.243 at p=0.016, F-criterion 6.329 at p<0.001), segmented neutrophils (r=0.231 at p=0.022, F-criterion 5.900 at p<0.001), eosinophils (r=0.336 at p=0.02, F-criterion 1.900 at p=0.002), C-reactive protein (r=0.431 at p=0.01, F-criterion 3.40 at p=0.002) increase in liver density in the form of steatosis or fibrosis according to ultrasound scanning data (r=0.427 at p=0.042, F-criterion 5.579 at p=0.022), level blood sodium (r=0.476 at p=0.011, F-criterion 4.723 at p=0.011). The following parameters were combined into one integral model using the linear modeling method: RDW-CV, leukocyte count, segmented neutrophils, eosinophils, total blood cholesterol, increased liver density according to ultrasound scan data in the form of steatosis or fibrosis and chronic obstructive pulmonary disease. The F-criterion of the full model was 4.8, the coefficient of determination R2=0.407; R2>0.3, significance level p=0.02. Thus, the resulting medical and mathematical model was generally acceptable. The threshold values of indicators were determined using the method of classification trees. This model visualized that the diagnostic levels of the scale values were: cholesterol level – 6.27 mmol/L, RDW-CV – 16.0%, neutrophils – 50%, eosinophils – 6%, leukocytes – 8.9%. In addition, the decision tree. shows that in individuals with cholesterol levels less than 6.27 mmol/l, without an increase in liver density according to ultrasound data, no obstructive pulmonary disease/RDW-CV level is less than 16%, only 1 patient had MFA, versus 24 patients who had cholesterol levels less than 6, 27 mmol/l, had an increase in liver density according to ultrasound, and the level of inflammatory granulocytes: neutrophils above 70%, eosinophils above 6% against the background of the total number of leukocytes 8.9x109 (l). In individuals with a GC above 6.27 mmol/L, MFA was observed in 14 people (100%) Funding Acknowledgement Type of funding sources: None. Diagnostic model