拓数据分析,以确定心脏再同步治疗患者,从植入式心脏转换器-除器中获益
Boglárka Veres1, Walter Richard Schwertner1, Márton Tokodi1
1Heart and Vascular Center, Semmelweis University, Városmajor Str. 68, 1122, Budapest, Hungary.
概括
拓数据分析确定了特定的患者群体,他们受益于用除器 (CRT-D) 进行心脏再同步治疗,而不是用心脏起器 (CRT-P). 这种方法有助于选择最佳的CRT设备治疗,以改善生存结果.
科学领域:
- 心脏病学 心脏病学
- 医疗数据分析 医学数据分析
- 生物统计学 生物统计学
背景情况:
- 目前关于心脏再同步治疗 (CRT) 的指导方针涉及多个因素,但很难确定哪些患者将从使用除器 (CRT-D) 与起器 (CRT-P) 的CRT中获益最多.
- 选择最佳的CRT装置 (CRT-D与CRT-P) 仍然是改善患者存活率的临床挑战.
研究的目的:
- 使用拓数据分析 (TDA) 来识别不同的患者现象组.
- 为了确定哪些现象群体在CRT-P相比,在CRT-D中经历了更好的生存期.
主要方法:
- 在2000年至2018年期间接受CRT-D或CRT-P的2603名患者的分析.
- 将TDA应用于由25个临床特征构建的患者相似性网络.
- 鉴定和比较现象组特征和生存结果.
主要成果:
- 根据临床特征和结果,TDA揭示了五个不同的现象组.
- 现象组2 (非缺血性病因) 和5 (缺血性病因) 与CRT-P相比,CRT-D的生存率显著更好.
- 调整后的危险比率表明,在现象组2 (0.61) 和5 (0.84) 中,CRT-D的生存率有所改善.
结论:
- TDA有效地识别患者现象组,区分缺血和非缺血病因.
- 这种方法可以指导那些最有可能受益的患者选择CRT-D而不是CRT-P,从而有可能改善生存率.
- 使用TDA同时评估多种临床特征,可以提高个性化的CRT设备选择.
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