Application of Charlson Comorbidity Index to assess prognosis of 18-month mortality in patients with acute myocardial infarction
Aim. To evaluate the prognostic value of the Charlson Comorbidity Index (CCI) for predicting 18-month all-cause mortality and develop a nomogram for predicting 18-month mortality in acute myocardial infarction (MI) patients. Materials and methods. The prospective, single-center, observational study...
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Siberian State Medical University (Tomsk)
2024-07-01
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| Series: | Бюллетень сибирской медицины |
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| Online Access: | https://bulletin.ssmu.ru/jour/article/view/5666 |
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| author | T. H. Hoang V. V. Maiskov I. A. Merai Zh. D. Kobalava |
| author_facet | T. H. Hoang V. V. Maiskov I. A. Merai Zh. D. Kobalava |
| author_sort | T. H. Hoang |
| collection | DOAJ |
| description | Aim. To evaluate the prognostic value of the Charlson Comorbidity Index (CCI) for predicting 18-month all-cause mortality and develop a nomogram for predicting 18-month mortality in acute myocardial infarction (MI) patients. Materials and methods. The prospective, single-center, observational study included 712 consecutive patients with acute MI undergoing coronary angiography within 24 hours after hospitalization. The primary endpoint was 18-month all-cause mortality. The logistic regression analysis was adopted to identify independent prognostic factors. A nomogram for predicting the endpoint was developed using the multivariate analysis. The discriminative ability of the CCI and a nomogram were evaluated using the receiver-operating characteristic (ROC) curve analysis. Results. Of the patients, 61% were male, median age was 65 years (interquartile range (IQR) was 56–74 years). Median CCI was 4 (IQR: 3–6) points. The mortality rate was 12.1% at 18 months with the area under the curve (AUC) of 0.797 for CCI (95% confidence interval (CI) 0.746–0.849; p < 0.001). The multivariate analysis revealed that CCI (odds ratio (OR) 1.28; 95% CI 1.08–1.52; p = 0.004), age (OR 1.06; 95% CI 1.02–1.09; p = 0.002), and three-vessel coronary artery disease (OR 2.60; 95% CI 1.36–4.98; p = 0.004), incorporated into the nomogram, were independent predictive factors of an adverse outcome. The nomogram showed good discrimination in predicting 18-month mortality in patients with acute MI (AUC = 0.819; 95% CI 0.767–0.870; p < 0.001; sensitivity 65.1%; specificity 88.2%). Conclusion. CCI was independently associated with and moderately predicted 18-month mortality in patients with acute MI. The proposed nomogram facilitated early identification of high-risk patients, allowing for the implementation of more effective treatment strategies and reducing acute MI mortality |
| format | Article |
| id | doaj-art-cae0a66d4cc04dd9ae6e006973fbe409 |
| institution | Kabale University |
| issn | 1682-0363 1819-3684 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | Siberian State Medical University (Tomsk) |
| record_format | Article |
| series | Бюллетень сибирской медицины |
| spelling | doaj-art-cae0a66d4cc04dd9ae6e006973fbe4092025-08-20T03:37:41ZengSiberian State Medical University (Tomsk)Бюллетень сибирской медицины1682-03631819-36842024-07-012329110010.20538/1682-0363-2024-2-91-1003076Application of Charlson Comorbidity Index to assess prognosis of 18-month mortality in patients with acute myocardial infarctionT. H. Hoang0V. V. Maiskov1I. A. Merai2Zh. D. Kobalava3Pham Ngoc Thach University of Medicine; Tam Duc Heart HospitalPeoples’ Friendship University of Russia (RUDN University); Vinogradov City Clinical HospitalPeoples’ Friendship University of Russia (RUDN University); Vinogradov City Clinical HospitalPeoples’ Friendship University of Russia (RUDN University)Aim. To evaluate the prognostic value of the Charlson Comorbidity Index (CCI) for predicting 18-month all-cause mortality and develop a nomogram for predicting 18-month mortality in acute myocardial infarction (MI) patients. Materials and methods. The prospective, single-center, observational study included 712 consecutive patients with acute MI undergoing coronary angiography within 24 hours after hospitalization. The primary endpoint was 18-month all-cause mortality. The logistic regression analysis was adopted to identify independent prognostic factors. A nomogram for predicting the endpoint was developed using the multivariate analysis. The discriminative ability of the CCI and a nomogram were evaluated using the receiver-operating characteristic (ROC) curve analysis. Results. Of the patients, 61% were male, median age was 65 years (interquartile range (IQR) was 56–74 years). Median CCI was 4 (IQR: 3–6) points. The mortality rate was 12.1% at 18 months with the area under the curve (AUC) of 0.797 for CCI (95% confidence interval (CI) 0.746–0.849; p < 0.001). The multivariate analysis revealed that CCI (odds ratio (OR) 1.28; 95% CI 1.08–1.52; p = 0.004), age (OR 1.06; 95% CI 1.02–1.09; p = 0.002), and three-vessel coronary artery disease (OR 2.60; 95% CI 1.36–4.98; p = 0.004), incorporated into the nomogram, were independent predictive factors of an adverse outcome. The nomogram showed good discrimination in predicting 18-month mortality in patients with acute MI (AUC = 0.819; 95% CI 0.767–0.870; p < 0.001; sensitivity 65.1%; specificity 88.2%). Conclusion. CCI was independently associated with and moderately predicted 18-month mortality in patients with acute MI. The proposed nomogram facilitated early identification of high-risk patients, allowing for the implementation of more effective treatment strategies and reducing acute MI mortalityhttps://bulletin.ssmu.ru/jour/article/view/5666charlson comorbidity indexcomorbiditymortalitymyocardial infarctionnomogram |
| spellingShingle | T. H. Hoang V. V. Maiskov I. A. Merai Zh. D. Kobalava Application of Charlson Comorbidity Index to assess prognosis of 18-month mortality in patients with acute myocardial infarction Бюллетень сибирской медицины charlson comorbidity index comorbidity mortality myocardial infarction nomogram |
| title | Application of Charlson Comorbidity Index to assess prognosis of 18-month mortality in patients with acute myocardial infarction |
| title_full | Application of Charlson Comorbidity Index to assess prognosis of 18-month mortality in patients with acute myocardial infarction |
| title_fullStr | Application of Charlson Comorbidity Index to assess prognosis of 18-month mortality in patients with acute myocardial infarction |
| title_full_unstemmed | Application of Charlson Comorbidity Index to assess prognosis of 18-month mortality in patients with acute myocardial infarction |
| title_short | Application of Charlson Comorbidity Index to assess prognosis of 18-month mortality in patients with acute myocardial infarction |
| title_sort | application of charlson comorbidity index to assess prognosis of 18 month mortality in patients with acute myocardial infarction |
| topic | charlson comorbidity index comorbidity mortality myocardial infarction nomogram |
| url | https://bulletin.ssmu.ru/jour/article/view/5666 |
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