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Multiparametric prognostic scores in chronic heart failure with reduced ejection fraction: a long-term comparison
- Source :
- European Journal of Heart Failure. 20:700-710
- Publication Year :
- 2017
- Publisher :
- Wiley, 2017.
-
Abstract
- Aims Risk stratification in heart failure (HF) is crucial for clinical and therapeutic management. A multiparametric approach is the best method to stratify prognosis. In 2012, the Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score was proposed to assess the risk of cardiovascular mortality and urgent heart transplantation. The aim of the present study was to compare the prognostic accuracy of MECKI score to that of HF Survival Score (HFSS) and Seattle HF Model (SHFM) in a large, multicentre cohort of HF patients with reduced ejection fraction. Methods and results We collected data on 6112 HF patients and compared the prognostic accuracy of MECKI score, HFSS, and SHFM at 2- and 4-year follow-up for the combined endpoint of cardiovascular death, urgent cardiac transplantation, or ventricular assist device implantation. Patients were followed up for a median of 3.67 years, and 931 cardiovascular deaths, 160 urgent heart transplantations, and 12 ventricular assist device implantations were recorded. At 2-year follow-up, the prognostic accuracy of MECKI score was significantly superior [area under the curve (AUC) 0.781] to that of SHFM (AUC 0.739) and HFSS (AUC 0.723), and this relationship was also confirmed at 4 years (AUC 0.764, 0.725, and 0.720, respectively). Conclusion In this cohort, the prognostic accuracy of the MECKI score was superior to that of HFSS and SHFM at 2- and 4-year follow-up in HF patients in stable clinical condition. The MECKI score may be useful to improve resource allocation and patient outcome, but prospective evaluation is needed.
- Subjects :
- Heart transplantation
medicine.medical_specialty
Framingham Risk Score
Ejection fraction
business.industry
medicine.medical_treatment
Area under the curve
030204 cardiovascular system & hematology
medicine.disease
Transplantation
03 medical and health sciences
0302 clinical medicine
Internal medicine
Ventricular assist device
Heart failure
medicine
Cardiology
030212 general & internal medicine
Cardiology and Cardiovascular Medicine
business
Prospective cohort study
Subjects
Details
- ISSN :
- 13889842
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- European Journal of Heart Failure
- Accession number :
- edsair.doi...........1a23c3e21a53aecd3cf410d5df64e3a1