Role of simple clinico-laboratory parameters in one-year prediction of lEF HF coursein the epoch of high-tech methods of health care: The Available Prognosis study
Background. Despite the existence of multiple regional scales for one-year prediction of CHF course developed in European countries and the USA, which are necessary for identifying the type of high-tech health care (HTMC), the experience of using these resources in Russian patients is negative. Aim. To identify among routine indexes predictors of one-year prognosis for systolic CHF in Russian patients and to develop subsequently a medical calculator. Materials and methods. A prospective study was performed on 212 patients with FC II-IV systolic CHF and LV EF ≤35%. Results. A descriptive model was developed for calculation of 12-month outcome probabilities in CHF patients, including the following variables: frequency of respiratory movements (FRM); orthostatic systolic BP (SBP); % RDW (red cell distribution width) and relative lymphocyte count in serum; and age of CHF onset. Conclusion. The Available Prognosis study performed on Russian patients with low EF CHF (lEF HF) showed a considerable correlation of the short-term prediction with routine indexes, such as age of CHF onset, FRM, and orthostatic SBP. Also, the study confirmed the predictive value for heterogeneity of % RDW and relative lymphocyte count in serum. Some traditional risk factors (RFs) (gender, BWI, ischemic etiology of HF, history of MI, high serum levels of creatinine and uric acid and low serum albumin, low GFR, wide QRS complex, history of ventricular tachycardia, and concurrent COPD) may lose their role in determination of short-term prediction for patients with lEF HF in the conditions of maximum CHF stabilization with optimum drug therapy, correction of metabolic disorders, and electrophysiological treatment.