1. Application of the Seattle Heart Failure Model in Patients on Cardiac Resynchronization Therapy
- Author
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Paolo Pieragnoli, Giosuè Mascioli, Nicola Vitulano, Tiziana De Santo, Luigi Padeletti, Ilaria Ricceri, Fulvio Bellocci, Laura Perrotta, Maria Cristina Porciani, Antonio Michelucci, Giulia Pontecorboli, Giuseppe Ricciardi, Marco Chiostri, and Michele Emdin
- Subjects
medicine.medical_specialty ,New York Heart Association Class ,business.industry ,medicine.medical_treatment ,Cardiac resynchronization therapy ,General Medicine ,Implantable defibrillator ,medicine.disease ,Transplantation ,Heart failure ,Internal medicine ,medicine ,Clinical endpoint ,Cardiology ,In patient ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: The Seattle Heart Failure Model (SHFM) is a multimarker risk assessment tool able to predict outcome in heart failure (HF) patients. Aim: To assess whether the SHFM can be used to risk-stratify HF patients who underwent cardiac resynchronization therapy with (CRT-D) or without (CRT) an implantable defibrillator. Methods and Results: The SHFM was applied to 342 New York Heart Association class III-IV patients who received a CRT (23%) or CRT-D (77%) device. Discrimination and calibration of SHFM were evaluated through c-statistics and Hosmer-Lemeshow (H-L) goodness-of-fit test. Primary endpoint was a composite of death from any cause/cardiac transplantation. During a median follow-up of 24 months (25th–75th percentile [pct]: 12–37 months), 78 of 342 (22.8%) patients died; seven patients underwent urgent transplantation. Median SHFM score for patients with endpoint was 5.8 years (25th–75th pct: 4.25–8.7 years) versus 8.9 years (25th–75th pct: 6.6–11.8 years) for those without (P < 0.001). Discrimination of SHFM was adequate for the endpoint (c-statistic always ranged around 0.7). The SHFM was a good fit of death from any cause/cardiac transplantation, without significant differences between observed and SHFM-predicted survival. Conclusion: The SHFM successfully stratifies HF patients on CRT/CRT-D and can be reliably applied to help clinicians in predicting survival in this clinical setting. (PACE 2012; 35:88–94)
- Published
- 2011