Прогнозирование развития пароксизма фибрилляции предсердий у пациентов с постинфарктным кардиосклерозом

Aim . Create an algorithm predicting the risk of development of paroxysmal atrial fibrillation in patients with coronary heart disease on the background of post-infarction cardiosclerosis (PICS). Material and Methods. There was conducted the deep analysis of a number of laboratory and functional indicators (indicators of peroxidation of proteins, lipids, antioxidant protection and skin microcirculation) at 85 patients with atrial fibrillation (AF). All patients were divided into 4 groups: patients with paroxysmal and chronic AF without PICS (27 people), patients with paroxysmal and chronic AF with PICS (12), patients with permanent AF without PICS (26) and patients with permanent form of AF with PICS (20). Results. There was created the mathematical model to predict the development of atrial fibrillation in patients with PICS with calculation of the odds ratio of atrial fibrillation. Methods of correlation and factor analysis revealed the greatest value for the prognosis of paroxysmal atrial fibrillation in patients with PICS two factors: the total level of deep oxidation products of protein and an indicator of microcirculation by laser Doppler flowmetry. The diagnostic sensitivity of the developed prognostic model was 86%, specificity of the test – 94%, the diagnostic efficiency of the test – 90%. Conclusion. The study has been proven clinical diagnostic and prognostic value of a comprehensive study of indicators of oxidation-reduction reactions, and the microcirculation indices in combination with standard laboratory and instrumental investigations in patients with AF. The developed mathematical model allows to predict the development of atrial fibrillation in patients with PICS.