Predictors of adverse events in patients with ischemic chronic heart failure with reduced ejection fraction and renal dysfunction
Keywords:Heart Failure, Predictors, Kidney
Chronic heart failure (CHF) is one of the most significant health, economic and social problems of the XXI century.
Aim. To identify predictors of adverse events in patients with ischemic chronic heart failure with reduced ejection fraction and renal dysfunction taking into account the results of three years observation.
Materials and methods. In order to reveal prognostic factors of adverse events, 140 patients (81.4% men, mean age 60 (54.5–68) years) with ischemic chronic heart failure with reduced ejection fraction and renal dysfunction were investigated. For determination of dependent and independent prognostic factors of adverse events ROC-analysis, univariate and multivariate Cox proportional hazard regression analyses were done.
Results. In order to determine independent predictors of major adverse cardiovascular events 18 hazards indicators were analyzed using Cox proportional. By results of multivariate regression analysis Cox proportional hazards found that the optimal cut-off point in excess distribution age>65 years, the risk of cumulative endpoint in patients with ischemic heart failure significantly increased in 2.75 times (95% CI 1.67–4.50; p=0.001), heart rate>79 beats minute – in 2.26 times (95% CI 1.32–3.87, p=0.002) and the presence of lower than optimal point distribution values SAP≤140 mmHg – the risk is increased 1.83-fold (95% CI 1.02–3.64, p=0.03), eGFR≤70.27 ml/min/1,73m2 – at 1.73 times (95% CI 1.09–2.75; p=0.02), EF≤34,23% – to 1.94 times (95% CI 1.21–3.11, p=0.005), HDL≤0.86 mmol/l – 1.83 times (95% CI 1.12–2.99, p=0.01).Conclusion. It was revealed that in patients with ischemic chronic heart failure with reduced ejection fraction and renal dysfunction within three years of observation there are such independent predictors of adverse cardiovascular events as age, heart rate, systolic blood pressure, glomerular filtration rate, left ventricular ejection fraction and HDL levels.
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