pmjТихоокеанский медицинский журналPacific Medical Journal1609-1175TGMU10.34215/1609-1175-2026-2-82-85pmj-3148Research ArticleНАБЛЮДЕНИЯ ИЗ ПРАКТИКИPRACTICE OBSERVATIONSПрогнозирование обструктивного поражения коронарных артерий у пациента с острым коронарным синдромом без подъема сегмента ST (клинический случай)Prediction of obstructive coronary artery disease in patients with non-ST elevation acute coronary syndrome (a clinical case)https://orcid.org/0000-0003-3545-3862ЦиванюкМ. М.TsivanyukM. M.

Циванюк Михаил Михайлович – к.м.н., старший научный сотрудник лаборатории анализа больших данных в здравоохранении и медицине Дальневосточного ФУ; заведующий отделением рентгенохирургических методов диагностики и лечения Владивостокской клинической больницы № 1

690922, Владивосток, о. Русский, п. Аякс, 10; 690078, Владивосток, ул. Садовая, 22; тел.: +7 (914) 791-60-63

Mikhail M. Tsivanyuk - Cand. Sci. (Med.), Senior Researcher at the Laboratory for Big Data Analysis in Healthcare and Medicine, Far EFU, Head of the Department of Department of Interventional Radiology, Vladivostok Clinical Hospital No. 1.

10 Ajax Bay, Russky Island, Vladivostok, 690922; 22 Sadovaya str., Vladivostok, 690078; tel.: +7 (914) 791-60-63

m_tsivanyuk@list.ruГельцерБ. И.GeltserB. I.

Владивосток

Vladivostok

Владивостокская клиническая больница № 1; Дальневосточный федеральный университетРоссияVladivostok Clinical Hospital No 1; Far Eastern Federal UniversityRussian FederationДальневосточный федеральный университетРоссияVladivostok Clinical Hospital No 1Russian Federation202619072026028285Copyright © Циванюк М.М., Гельцер Б.И., 20262026Циванюк М.М., Гельцер Б.И.Tsivanyuk M.M., Geltser B.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tmj-vgmu.ru/jour/article/view/3148

Актуальные клинические подходы подчеркивают значимость ранней стратификации риска у пациентов с острым коронарным синдромом без подъема сегмента ST. В то же время определение оптимальной стратегии ведения пациентов с невысоким риском неблагоприятных исходов остается сложной клинической задачей. Разработанная нами модель на основе стохастического градиентного бустинга обеспечивает точную оценку вероятности обструктивного поражения коронарных артерий в первые часы госпитализации, поэтапно интегрируя данные первичного осмотра, а также исследований через 1 и 3 часа. В работе представлен клинический случай, иллюстрирующий ее практическое применение.

Current clinical guidelines emphasize the need for early risk stratification in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Meanwhile, the choice between invasive and conservative strategies for patients at low risk for adverse outcomes remains challenging. Our predictive model, developed using stochastic gradient boosting, highly accurately assesses the probability of obstructive coronary artery disease in the first hours of hospitalization. Data from three time points are sequentially integrated: the initial examination, one hour later (complete blood count), and three hours later (biochemistry and echocardiography). This article presents a clinical case that illustrates the practical application of the model.

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The authors declare that there are no conflicts of interest present.