Post-hospital Mortality Forecast in Young and Middle-Aged Patients with Myocardial Infarction
I Study Objective: to find out the role of anamnestic, clinical-laboratory and instrumental characteristics in the risk of mortality in young and middle-aged patients with myocardial infarction (MI), and to propose a risk classification model for this patient cohort. Materials and Methods. The study included 424 patients with confirmed MI in patients of  100 upon admission, cardiogenic shock, postinfarction cardiosclerosis, NLI of > 4.52, mitral regurgitation, Hb of  4). Multi-factor analysis allowing to determine the cumulative role of the above parameters demonstrated that the risk of mortality within 12-month follow-up has statistically significant correlation with NLI of > 4.52 (р = 0.04), Hb of  100 upon admission, cardiogenic shock, postinfarction cardiosclerosis, NLI of > 4.52, mitral regurgitation, Hb of  4). Multi-factor analysis allowing to determine the cumulative role of the above parameters demonstrated that the risk of mortality within 12-month follow-up has statistically significant correlation with NLI of > 4.52 (р = 0.04), Hb of < 130 g/L (р = 0.013), discharge LVEF of < 40% (р = 0.0001). Area under ROC curve of the resulting risk model was 0.88, with sensitivity and specificity of 85.7% and 90.9%, respectively. Conclusion. This prognostic model is cost effective and allows classifying patients with high mortality risk within first follow-up year. Calculation of an individual mortality risk will make it possible to optimise the strategy of therapy and secondary prevention in this group of patients.