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Add-on grade-ranking scale for assessing thrombotic risk in patients with ischemic heart disease and percutaneous
Nadezhda V Storozhuk1, Aleksey B Panasenko2, Boris G Storozhuk1
1National Pirogov Memorial Medical University, Vinnytsia, Ukraine.
Insights
This study developed a new risk scale to predict thrombotic complications in patients undergoing coronary angioplasty. The scale uses key hemostasis markers and patient history to accurately identify high-risk individuals.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Biostatistics
Background:
- Thrombotic complications are a significant risk following coronary angioplasty.
- Accurate risk stratification is crucial for preventing adverse events in these patients.
- Existing risk assessment tools may not fully capture the complexity of hemostatic changes.
Purpose of the Study:
- To develop an informative grade-ranking scale for predicting thrombotic complications after coronary angioplasty.
- To utilize principal component analysis to simplify complex hemostatic data.
- To create a matrix for efficient patient classification based on thrombotic risk.
Main Methods:
- Analysis of data from 70 patients with coronary heart disease undergoing percutaneous coronary angioplasty.
- Measurement of soluble fibrin (rf), fibrinogen (fg), D-dimer (dd), and protein C (pc) levels.
- Inclusion of diabetes mellitus and history of restenosis in the risk assessment model.
Main Results:
- Principal component analysis identified two key matrices explaining 70% of data variance: (rf+dd) and (fg+pc).
- These components formed the basis for an initial thrombotic risk indicator.
- A second indicator, (rf/dd×100), incorporating diabetes and restenosis history, further refined risk assessment.
Conclusions:
- The developed grade-ranking scale effectively predicts thrombotic complications in patients undergoing coronary angioplasty.
- The scale offers a simplified yet informative approach to risk stratification.
- This tool can aid clinicians in proactively managing patients at high risk of thrombotic events.
Objective:
Introduction: The anticipation of the development of thrombotic complications in coronary angioplasty patients helps to prevent this dangerous complication. Development of the available informative scales on the basis of mathematical methods taking into account the main clinical and biochemical parameters significantly simplifies the classification of patients in terms of thrombotic risk. The aim of the paper is to concentrate information on the state of hemostasis in the studied category of patients using the method of the main components and to obtain a matrix with minimal loss of information, which is convenient for analysis and the creation of a grade-ranking scale.
Patients And Methods:
Materials and methods: Data of 70 patients with coronary heart disease and percutaneous coronary angioplasty were analyzed. The level of soluble fibrin, fibrinogen, D-dimer, protein C, and ratios rf/dd×100 were determined, and also the presence of diabetes mellitus and restenosis in the history was considered.
Results:
Results: As a result of a stepwise study using the method of the main components, in the first stage two most singular matrices were obtained that describe 70% of the entire data variance (one of them is the component rf+dd, and the second one is fg+pc), which led to the first indicator of the level of thrombotic risk. At the second stage, the level of thrombotic risk was clarified, taking into consideration the presence of diabetes and history of restenosis, and it is recommended to use a second indicator for its determination (rf/dd×100).
Conclusion:
Conclusions: The presented grade-ranking scale scale allows the anticipation of the development of thrombotic complications in the studied category of patients with high probability.
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