Laboratory predictors in patients with acute myocardial infarction combined with nonalcoholic fatty liver disease
The aim of the study was to test a mathematical model for predicting the course of acute myocardial infarction period (MI) with Q wave, combined with hepatic steatosis (HS) or non-alcoholic steatohepatitis (NASH). Materials and methods. The study involved 74 patients with acute Q-positive left ventricular MI of different location, combined with HS (67 patients) and NASH (7 patients), aged 36 to 88 years (average age 64 ± 1 years). Among them there were 35 women and 39 men. To predict the outcome of acute MI period, combined with HS or NASH, we used an approach based on data mining (Data Mining) with mathematical tools of the decision tree method. Results. The decision tree algorithms allowed determine the laboratory parameters (attributes) and then use them as input data. Construction of contingency tables determined the adequacy of classification of these attributes. The accuracy of the calculation results is 98.65 %. Decision tree highlighted three most important laboratory parameters: aspartate aminotransferase (ASAT), age and red blood cells concentration. The significance of ASAT was 60.9 %, age — 25.8 %, and red blood cells — 13.3 %. With regard to Rules of visual analyzer, only the first rule earns confidence, in which the accuracy reaches 100 %, and the influence on the death (support) — 52.9 %. Conclusions. The decision tree algorithm identified important prognostic markers of acute MI and non-alcoholic fatty liver disease: ASAT and age. It determined that if patient’s ASAT level is less than 0.546 mmol/l, and age is less than 81, then a favorable outcome can be predicted with 98.65% accuracy.
Full Text:PDF (Русский)
Tyc' SN, Gukov AG, Parhomchuk DS, Percova YU G. Regional system of organization and rendering emergency medical aid for patients with acute coronary syndrome at Lugansk region. Ukrainian Cardiology Journal. 2014;6:78-82. (In Russian).
Vyalov SS. Non-alcoholic fatty liver disease as a component of metabolic syndrome: fatty liver and atherosclerosis. Consilium Medicum. 2012;14(5):41-45. (In Russian).
Gu LF, Wang YQ, Fan JG. Research advances in the impact of nonalcoholic fatty liver disease on cardiac structure and function. Zhonghua Gan Zang Bing Za Zhi. 2016; Jun., 24(6):461-464. doi: 10.3760/cma.j.issn.1007-3418.2016.06.015.
Sîrbu O, Floria M, Dăscălița P, Şorodoc V, Şorodoc L. Non-alcoholic fatty liver disease-From the cardiologist perspective. Anatol J Cardiol. 2016 Jul;16(7):534-41. doi: 10.14744.
Kolesnikova EV. Modern patient with liver diseases and pathology of cardiovascular system: what choice to make? Suchasna gastroenterologiya. 2014;76(2):85-94. (In Russian). 6. Mekhtiev SN, Grinevich VB, Kravchuk YU A, Brashchenkova AV. Non-alcoholic fatty liver disease: clinical picture, diagnostics and treatment. Lechashchij vrach. 2008;2:29-32. (In Russian).
Shul'pekova YU O. Аlgorithm of examination and treatment of patients with hepatitis and hepatosis. Suchasna gastroenterologiya. 2009;46(2):101-107. (In Russian).
Vecchione G, Grasselli E, Voci A et al. Silybin counteracts lipid excess and oxidative stress in cultured steatotic hepatic cells. World J Gastroenterol 2016; Jul. 14, 22 (26):6016-6026. doi: 10.3748/wjg.v22.i26.6016.
Tkach S.M. Prevalence, course, diagnostics and strategy of treatment of non-alcoholic fatty liver disease. Zdorov’ya Ukraїni. 2009;1-2:63-65. (In Russian).
Golabi P., Locklear C.T., Austin P. et al. Effectiveness of exercise in hepatic fat mobilization in non-alcoholic fatty liver disease: Systematic review. World J Gastroenterol. 2016; Jul 21, 22(27):6318-6327. doi: 10.3748/wjg.v22.i27.6318.
Calderon RM, Cubeddu LX, Goldberg RB, Schiff ER. Statins in the Treatment of Dyslipidemia in the Presence of Elevated Liver Aminotransferase Levels: A Therapeutic Dilemma. Mayo Clin Proc. 2010;85(4):349– 356.
Argo CK, Loria P, Caldwell SH, Lonardo A. Statins in liver disease: A molehill, an iceberg, or neither? Hepatology. 2008;48(2):662–669.
Barsegyan AA, Kupriyanov MS, Stepanenko VV, Holod II. Methods and models of data analysis: OLAP and Data Mining. SPb.: BHV-Peterburg; 2004. 336р. (In Russian).
Ph. Gabriel Steg, Stefan K. James, Dan Atar et al. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology. Eur Heart J 2012;(33):2569–2619. doi:10.1093/eurheartj/ehs215
Copyright (c) 2017 EMERGENCY MEDICINE
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2018