Long-term risk predictors of adverse events in patients with chronic heart failure

Abstract

Target. To identify predictors of the risk of adverse events over a three-year period in patients with chronic heart failure (CHF). Materials and methods. A retrospective study was conducted on 278 people diagnosed with CHF in patients with coronary heart disease (CHD). Statistical data processing was carried out using Excel and XLSTAT programs with linear regression calculations. Results. In the study group, there were 181 male patients and 97 female patients. Among the concomitant diseases, the most common diseases were endocrine system diseases, obesity and gastrointestinal pathology. According to Charlson comorbidity index calculations, 121 patients had an index of 6 or higher, which corresponds to a possible 10-year survival rate of less than 21%. When analyzing the data, patients with CHF had a three-year survival rate of 67.3% of the study group, 32.7% of patients died. A statistically significant direct relationship between three-year survival was identified with the following indicators: age over 66 years, stage IIB-III CHF, Echo-CG data (low LVEF, left ventricular diameter, systolic pressure in the pulmonary artery (SPAP), the presence of hypertension (HBP) and atrial fibrillation (AF), Charlson comorbidity index more than 5 points, glomerular filtration rate (GFR) less than 60 ml/min, complete blood count (CBC) data - a decrease in hemoglobin level below 131 g/l and an increase in ESR level above 14 mm/h Surgical interventions such as coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) were associated with better patient survival. Conclusion. The identified predictors of unfavorable outcome will improve the prediction of outcomes in patients with CHF. Performing coronary revascularization in patients with coronary artery disease complicated by CHF was associated with better patient survival. In order to ensure qualified monitoring of patients with CHF and ensure continuity of management of these patients, it seems relevant to create a specialized office for the management of patients with CHF on the basis of the State Institution of the Republic of Kazakhstan “Clinical Cardiology Dispensary”.