Comparison of conventional risk factors in middle-aged versus elderly diabetic and nondiabetic patients with myocardial infarction: prediction with decision–analytic model

Abstract

Background:We sought to predict occurrence of myocardial infarction (MI) by means of a classification and regression tree (CART) model by conventional risk factors in middle-aged versus elderly (age ⩾65years) diabetic and nondiabetic patients from the Modares Heart Study. Method: A total of 469 patients were randomly selected and categorized into two groups according to clinical diabetes status. Group I consisted of 238 diabetic patients and group II consisted of 231 nondiabetic patients. Our population was MI positive. The outcome investigated was diabetes mellitus. We used a decision-analytic model to predict the diagnosis of patients with suspected MI. Results: We constructed 4 predictive patterns using 12 input variables and 1 output variable in terms of their sensitivity, specificity and risk. The differences among patterns were due to inclusion of predictor variables. The CART model suggested different variables of hypertension, mean cell volume, fasting blood sugar, cholesterol, triglyceride and uric acid concentration based on middle-aged and elderly patients at high risk for MI. Levels of biochemical measurements identified as best risk cutoff points. In evaluating the precision of different patterns, sensitivity and specificity were 47.9-84.0% and 56.3-93.0%, respectively. Conclusions: The CART model is capable of symbolizing interpretable clinical data for confirming and better prediction of MI occurrence in clinic or in hospital. Therefore, predictor variables in pattern could affect the outcome based on age group variable. Hyperglycemia, hypertension, hyperlipidemia and hyperuricemia were serious predictors for occurrence of MI in diabetics.

A Simple Prediction Model of Hyperuricemia for use in a Rural Setting

“…In recent years, some scholars have successfully applied the classi cation tree model to predict myocardial infarction [17], multi-drug resistant tuberculosis [18], portal vein thrombosis in patients with acute pancreatitis [19] and other internal or surgical diseases, and its application in medical-related elds has proven its effectiveness. However, classi cation trees also have some shortcomings.…”

A Descriptive Study on Risk Factors among Acute Myocardial Infarction Patients Admitted to the Coronary Care Unit of Prince Mitab Hospital Sakaka Aljouf

“…[2][3][4][5] The number of admission to cardiac care unit in prince Mitab hospital shows a systematic increase from 372 admissions in 2013 to 533 in year 2015, similarly patients admitted with MI has also shown an increase over the three-year study period except for year 2014. Premenopausal women have less incidence of CHD in the age matched men.…”

“…[5][6] In many countries CAD is the major cause of premature deaths. [7,8] Over the age of 35 years CAD is responsible for one-third of all deaths in United States of America.…”

“…[1] Patients of stroke or myocardial infarction (MI) are at an increased risk of recurrence of these events. [2][3][4][5] Identifying such patients and offering them preventive treatment would prevent such recurrence and improve survival.…”

Коморбідність, Серцево-Судинна Патологія І Лікування Гіперурикемії – Чи Запобігає Захворюванню Алопуринол? (Огляд Літератури)

“…У цьому випадку важливо, що СК викликає агрегацію еритроцитів за механізмом зменшення дзета-потенціалу еритроцитів, а еритроцитарні агрегати збільшують в'язкість крові на низьких швидкостях зсуву, що і збільшує ризик атеротромбозу [29]. Доведено, що гіперглікемія, гіпертензія, гіперліпідемія і гіперурикемія є серйозними предикторами виникнення ІМ за ЦД [16].…”