Study On The Correlation Between The High Risk Population Of Heart Failure After Myocardial Infarction And TCM Constitution And Syndrome Types

Objective: The purpose of this study is to obtain the risk factor score of heart failure after myocardial infarction based on the individual difference between heart failure within one year after myocardial infarction and heart failure within one year after myocardial infarction.Based on the risk factor scores,a risk prediction model was constructed to classify the high-risk groups,and the distribution characteristics of the TCM constitution and evidence patterns of the high-risk groups were clustered and analysed.This will guide the clinical use of Chinese medicine to intervene in the prognosis of post-myocardial infarction and serve as a recommendation for the prevention of heart failure after myocardial infarction in Chinese medicine clinics.Methods: A total of 436 cases hospitalized in the Affiliated Hospital of Changchun University of Traditional Chinese Medicine were used in this study.Among them,218 cases were diagnosed as myocardial infarction,218 cases were diagnosed as post-myocardial infarction heart failure and 218 cases were diagnosed as post-myocardial infarction chronic heart failure by Chinese and Western medicine.The general condition of patients(gender,age,BMI,etc.),admission ECG,some serum indicators,cardiac ultrasound,CAG,etc.were included.Control the patients in the myocardial infarction group and the post-myocardial infarction heart failure group,use the single-factor Log regression analysis to screen and analyze the various data,group the statistically significant results,and carry out the binary regression analysis to avoid data over-fitting,and finally build the nomogram of the early post-myocardial infarction heart failure through the screening results through the Rstudio software,and finally get the risk prediction model of post-myocardial infarction heart failure.The ROC curve was used to verify the predictive value of the model,and those with a predicted risk greater than 50% were classified as high-risk groups.Results:1.By linear regression analysis of the myocardial infarction group and the post-infarction heart failure group,the following 10 influencing factors P < 0.05 were statistically significant,resulting in a risk factor model of age(≥60 years),BMI,LVEF,NT-pro BNP,ventricular remodeling,residual stenosis(≥80%),number of lesion branches(≥2),history of type DM,history of HTN and HTN history for 5 years.2.The post-infarction heart failure risk prediction model constructed according to the influencing factors yielded AUC=0.977 R by Roc test with 97% accuracy,and the prediction model was put into R software to assign scores to derive nomogram charts with 93%accuracy by AUC test,thus the risk prediction model was found to be valid,and 128 cases of post-infarction heart failure at high risk were screened as valid.3.The TCM Body Mass Scale,the Evidence Factor Scale and the guidelines for the treatment of chronic heart failure were used to obtain the distribution of body mass types,the distribution of evidence factors and the distribution of evidence patterns in people at high risk of post-infarction heart failure.Conclusion:1.The components of the high-risk prediction model for heart failure after myocardial infarction were age(≥ 60 years),BMI,LVEF,NT-pro BNP,ventricular remodeling,residual stenosis(≥80%),number of lesion branches(≥2),history of type DM,history of HTN and history of HTN for more than 5 years.2.The most common type of physical condition in people at risk of heart failure after myocardial infarction is qi deficiency with phlegm and dampness,with qi deficiency,blood stasis and water stagnation being the most common.