| Objective: To study the value of efficacy predictors to PCI(Percutaneous Coronary Intervention)for the chronic heart failure with coronary heart diseaseMethods:(1)Prospective study:According to the diagnostic criteria,the patients were selected.All of the patients received GDMT.We screened the patients with the following characters:(1)a.under the age of 75 b.without diabetes c.suffered from angina pectoris and equivalent d.without pathologic Q waves according to the body surface electrocardiogram(2)a.patients over 75 years b.complicated with diabetes mellitus c.without angina pectoris and equivalent d.the body surface electrocardiogram show pathologic Q waves.The patients were followed-up for 1 year.Recording to the results of followed-up,the patients were divided into effective group,and ineffective group.A total of 29 cases were positive predictive factors,of which PCI was effective in 21 cases,calculated the positive predictive value(Positive predictive value,PPV).At the same time the patients didn’t had four factors-negative predictive factors,including 24 cases,of which 20 cases were invalid,4 cases were valid,calculating the negative predictive value(negative predictive value,NPV).We finally included 100 patients.There were 44 cases in effective group,the PCI was effective in 21 cases that predictive factors were positive,and the PCI was effective in 4 cases that predictive factors were negative,calculating the sensitivity(Sensitivity,Se).There were 56 cases in ineffective group,calculating the specificity(Specificity,Sp).(2)Retrospective study: We had included 105 patients in the early stage,the screening criteria were same to prospective studies.A total of 30 cases with positive predictive factors were found,of which PCI was effective in 25 cases,Computing the PPV.A total of 32 cases with negative predictive factors were found,of which PCI was invalid in 28 cases,Computing the NPV.We finally included 105 patients.There were 36 cases in effective group,the PCI was effective in 25 cases that predictive factors were positive,and the PCI was effective in 4 cases that predictive factors were negative,calculating the Se.There were 69 cases in ineffective group,calculating the Sp.(3)Among the 205 patients,59 cases with positive predictive factors were found,of which PCI was effective in 46 cases,Computing the PPV.A total of 56 cases with negative predictive factors were found,of which PCI was invalid in 48 cases,Computing the NPV.There were 80 cases in effective group,the PCI was effective in 46 cases that predictive factors were positive,and the PCI was effective in 8 cases that predictive factors were negative,calculating the Se.There were 125 cases in ineffective group,calculating the Sp.(4)Stratified analysis: The prospective study included a total of 100 patients.There were four predictive factors include age、diabetes、angina and equivalent symptoms 、pathological q wave.We calculated these PPV and NPV.Result: Prospective study:(1)Among 100 patients,there were 44 cases in the effective group and ineffective group had 56 cases.(2)Among 100 patients,A total of 29 cases were positive predictive factors,of which PCI was effective in 21 cases.the patients didn’t had four factors-negative predictive factors,including 24 cases,of which 20 cases were invalid,4 cases were valid,Se was 84%,PPV was 72.4%,Sp was 71.4%,NPV was 83.3%Retrospective study(1)Among 105 patients,there were 36 cases in the effective group and ineffective group had 69 cases.(2)A total of 30 cases with positive predictive factors were found,of which PCI was effective in 25 cases.32 cases with negative predictive factors were found,of which PCI was invalid in 28 cases.Se was 86.2%,PPV was 83.3%,Sp was 84.8%,NPV was 87.5%。Combined of two groups(1)Among 205 patients,there were 80 cases in the effective group and ineffective group had 125 cases.(2)Among 205 patients,59 cases with positive predictive factors were found,of which PCI was effective in 46 cases,A total of 56 cases with negative predictive factors were found,of which PCI was invalid in 48 cases.Se was 85.2%,PPV was77.9%,Sp was 78.7%,NPV was 85.7%.Stratified analysis :There were four predictive factors include age、diabetes、angina and equivalent symptoms 、pathological q wave.The positive predictive values were 76.6 %,41.2 %,70.4 % and 31.0 %,respectively.The negative predictive values were84.9%、53.1%、86.9% and 46.6%,respectively.When the patients who were younger than 75 years old,combined with angina and the equivalent symptom,the positive predictive value was 60.9 %,the negative predictive value was 72.5%.The positive predictive value was 65.7 % when the patients who were younger than 75 years old,with angina pectoris and equivalent symptoms and without diabetes mellitus,and the negative predictive value was 75%.Conclusion:(1)The patients who had following characters ——Under the age of 75,without diabetes,preoperative angina pectoris,without pathological Q wave were more likely to benefit from PCI treatment,the PPV was 77.9%(2)The patients with these characters ——patients over 75 years,with diabetes,without angina and ECG with pathological Q wave were more likely invalid.The NPV was 85.7%(3)The range of positive predictors that did not have four predictors was 54.8-65.7%.The negative predictive value was ranged from 67.8 to 75%... |
PDF Full Text Request