NJSC Semey Medical University, Semey, Kazakhstan.
University of Cambridge, Cambridge, Great Britain.
Kardiologiia. 2022 Jan 31;62(1):40-45. doi: 10.18087/cardio.2022.1.n1777.
Aim To identify a complex of predictors and to create a mathematical model for prognosis of atrial fibrillation (AF) in patients with ischemic stroke of undetermined etiology. Material and methods The study included 981 patients with ischemic stroke. Effects of the following factors were evaluated: gender, a history of stroke, a history of thromboembolism, presence of diabetes mellitus, grade of arterial hypertension, functional class (FC) of chronic heart failure (CHF), age, data of blood biochemistry, and data of coagulogram. The prognostic model was constructed using the binary logistic regression. The value of area under the ROC curve for the proposed prognostic model was calculated.Results The main predictors of AF in patients with ischemic stroke of undetermined etiology were CHF FC, a history of stroke, age, gender, values of cholesterol and prothrombin index, which were included into the final prognostic model. The sensitivity of the developed model was 83.5 % and the specificity was 85.5 %. The area under the ROC curve corresponding to the interrelation between the prognosis of AF and the regression function value was 0.921±0.012 with 95 % confidence interval: 0.898-0.944.Conclusion According to the results of the study, the probability of AF in patients with ischemic stroke increased with CHF progression, recurrent stroke, older age, female gender, and reduced prothrombin index and cholesterol level.
目的 确定预测因素的综合指标，并建立一种预测不明原因缺血性脑卒中患者心房颤动（AF）的数学模型。
材料与方法 本研究纳入了 981 例缺血性脑卒中患者。评估了以下因素的影响：性别、卒中史、血栓栓塞史、糖尿病、动脉高血压程度、慢性心力衰竭（CHF）的功能分级（FC）、年龄、血液生化数据和凝血酶原指数。使用二元逻辑回归构建预后模型。计算所提出的预后模型的 ROC 曲线下面积（AUC）值。
结果 不明原因缺血性脑卒中患者发生 AF 的主要预测因素为 CHF FC、卒中史、年龄、性别、胆固醇和凝血酶原指数，这些因素被纳入最终的预后模型。该模型的灵敏度为 83.5%，特异度为 85.5%。与回归函数值之间的 AF 预后相关的 ROC 曲线下面积为 0.921±0.012，95%置信区间为 0.898-0.944。
结论 研究结果表明，随着 CHF 进展、复发性卒中、年龄增长、女性性别以及凝血酶原指数和胆固醇水平降低，缺血性脑卒中患者发生 AF 的概率增加。
