Модель прогнозування перебігу хронічного обструктивного захворювання легень у пацієнтів із супутньою ішемічною хворобою серця

Chronic obstructive pulmonary disease (COPD) remains one of the most current health issues worldwide. Today, COPD is the third leading cause of death in the world, with 24% of patients dying within 5 years of diagnosis. The objective: to improve the diagnosis, increase the effectiveness of predicting the course of COPD in patients with concomitant coronary heart disease (CHD) by developing a new model for assessing the prognosis of COPD in patients with concomitant CHD. Materials and methods. The study included 133 patients of the GI “L. T. Malaya Therapy National Institute of NAMS of Ukraine”. Among the participants, there were 102 men (76.70%), and 31 women (23.30%). All of them were diagnosed COPD and concomitant CHD. The GOLD criteria (The Global Initiative for Chronic Obstructive Lung Disease, 2020) were used to diagnose COPD, and the severity was assessed by the CAT and mMRC scales. Genetic studies were conducted to identify polymorphisms in the EPHX1 gene (Tyr113His). Statistical data analysis included multifactorial modeling using logistic regression with the critical p-level 0.05. Results. According to the results of the study, it was found that the COPD course with frequent exacerbations in patients with CHD is significantly associated with the duration of COPD (odds ratio (OR) = 1.120, p = 0.035), the presence of a history of acute cerebrovascular accident (OR = 21.729, p = 0.032), as well as polymorphisms of the EPHX1 gene (TC: OR = 2.220, p = 0.048; CC: OR = 9.038, p = 0.001). Higher levels of high-density lipoprotein cholesterol in the blood were associated with an increased risk of exacerbations (OR = 4.992, p = 0.023). The developed prediction model demonstrated high prognostic accuracy (AUC = 0.756; 95.0% confidence interval [0.671–0.842], p = 0.001), sensitivity – 74.1%, specificity – 67.6% (AUC – Area Under the Curve). Conclusions. Significant clinical, functional, and genetic predictors of frequent exacerbations of COPD in patients with concomitant CHD were identified. The developed prognostic model can be used to identify risk groups and individualize treatment approaches. The obtained results emphasize the importance of genetic studies in patients with COPD and CHD, as well as the need for further research to confirm the effectiveness of the proposed model.