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Osipova O.A.

Belgorod State National Research University

Shekhovtsova L.V.

Belgorod State National Research University;
«Heart clinic»

Shepel R.N.

National Medical Research Center for Therapy and Preventive Medicine, Ministry of Health of the Russia

Radzishevskaya E.B.

Kharkiv National Medical University

Golovin A.I.

Belgorod State National Research University

Prediction of electrophysiological myocardial instability in the acute period of acute coronary syndrome with ST-segment elevation as an effectiveness indicator of the sudden cardiac death prevention

Authors:

Osipova O.A., Shekhovtsova L.V., Shepel R.N., Radzishevskaya E.B., Golovin A.I.

More about the authors

Journal: Russian Journal of Preventive Medicine. 2021;24(5): 81‑86

DOI: 10.17116/profmed20212405181

Read: 794 times

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PREDICTION OF ELECTROPHYSIOLOGICAL MYOCARDIAL INSTABILITY IN THE ACUTE PERIOD OF ACUTE CORONARY SYNDROME WITH ST-SEGMENT ELEVATION AS AN EFFECTIVENESS INDICATOR OF THE SUDDEN CARDIAC DEATH PREVENTION
PREDICTION OF ELECTROPHYSIOLOGICAL MYOCARDIAL INSTABILITY IN THE ACUTE PERIOD OF ACUTE CORONARY SYNDROME WITH ST-SEGMENT ELEVATION AS AN EFFECTIVENESS INDICATOR OF THE SUDDEN CARDIAC DEATH PREVENTION

To cite this article:

Osipova OA, Shekhovtsova LV, Shepel RN, Radzishevskaya EB, Golovin AI. Prediction of electrophysiological myocardial instability in the acute period of acute coronary syndrome with ST-segment elevation as an effectiveness indicator of the sudden cardiac death prevention. Russian Journal of Preventive Medicine. 2021;24(5):81‑86. (In Russ.)
https://doi.org/10.17116/profmed20212405181

Подписка 2025-2 (Russian Journal of Preventive Medicine)
 
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The mortality rate of patients with acute ST-segment elevation coronary syndrome (STEMI) in the first day after successful myocardial revascularization remains high, and therefore the search for markers for the prevention of sudden cardiac death (SCD) continues.

OBJECTIVE

To develop, test and implement an algorithm of a mathematical model for predicting the binary outcome «presence of risk of arrhythmic death/ absence of risk of arrhythmic death» for the prevention of the risk of SCD in patients with STEMI on the first day of the disease.

MATERIAL AND METHODS

During the period from 2015 to 2019, about 1000 people were hospitalized with ACS each year in two centers performing percutaneous coronary intervention (PCI). In order to build a prognostic model of the risk of SCD, 32 patients with STEMI who died on the first day due to the occurrence of fatal ventricular tachy-arrhythmias after effective percutaneous coronary intervention (PCI) were selected. The comparison group consisted of 90 surviving patients. The parameters of electrocardiograms (ECG) at admission to the department of cardiac intensive care unit were analyzed: QT, QTc, QTaps, JTs, JTars, SubTs and their variances QTd, QTcd, QTapcd, JTcd, JTapcd, SubTcd, on the basis of which a mathematical model for predicting SCD was developed, tested and implemented using discriminant analysis (YES). Statistical indicators are presented in the form of medians (Me, Mmin—Mmax).

RESULTS

The most informative indicators for the algorithm of the mathematical model for predicting the binary outcome «presence of risk of arrhythmic death/absence of risk of arrhythmic death» are: QTd (p=0.0004), coefficient of determination (R-Sqr.) = 0.384224; QTapcd (p=0.0022), R-Sqr.=0.178830; SubTd (p=0.000000), R-Sqr. = 0.286689. The algorithm «presence of risk of arrhythmic death» (PRAD) is developed, it corresponds to the equation: PRAD = QTd·0.3438 + QTapcd·0.0842 – SubTd·0.0864 – 19.5068, and the state «absence of risk of arrhythmic death» (ARAD) — the equation: ARAD = QTd·0.1997 – QTapcd·0.0148 + SubTd·0.3261 – 20.893. The proposed algorithm is easily implemented using spreadsheets and electronic computer.

CONCLUSION

The developed, tested and implemented mathematical model for predicting the risk of SCD «presence of risk of arrhythmic death/absence of risk of arrhythmic death» in patients with STEMI is highly effective and can be used for practical application on the first day of the disease.

Keywords:

acute coronary syndrome
prediction of sudden cardiac death
QT
QTapcd
SubTd

Authors:

Osipova O.A.

Belgorod State National Research University

Shekhovtsova L.V.

Belgorod State National Research University;
«Heart clinic»

Shepel R.N.

National Medical Research Center for Therapy and Preventive Medicine, Ministry of Health of the Russia

Radzishevskaya E.B.

Kharkiv National Medical University

Golovin A.I.

Belgorod State National Research University

Received:

02.09.2020

Accepted:

25.01.2021

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