Combined survival analysis of cardiac patients by a Cox PH model and a Markov chain |
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Authors: | Michal Shauly Gad Rabinowitz Harel Gilutz Yisrael Parmet |
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Institution: | (1) QURE – Department of Economics, Rovira i Virgili University, Av. Universitat, 1, Reus, 43204, Spain |
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Abstract: | The control and treatment of dyslipidemia is a major public health challenge, particularly for patients with coronary heart
diseases. In this paper we propose a framework for survival analysis of patients who had a major cardiac event, focusing on
assessment of the effect of changing LDL-cholesterol level and statins consumption on survival. This framework includes a
Cox PH model and a Markov chain, and combines their results into reinforced conclusions regarding the factors that affect
survival time. We prospectively studied 2,277 cardiac patients, and the results show high congruence between the Markov model
and the PH model; both evidence that diabetes, history of stroke, peripheral vascular disease and smoking significantly increase
hazard rate and reduce survival time. On the other hand, statin consumption is correlated with a lower hazard rate and longer
survival time in both models. The role of such a framework in understanding the therapeutic behavior of patients and implementing
effective secondary and primary prevention of heart diseases is discussed here. |
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