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.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).
Multiparametric prognostic scores in chronic heart failure with reduced ejection fraction: a long-term comparison / Agostoni, P; Paolillo, S; Mapelli, M; Gentile, P; Salvioni, E; Veglia, F; Bonomi, A; Corrà, U; Lagioia, R; Limongelli, G; Sinagra, G; Cattadori, G; Scardovi, Ab; Metra, M; Carubelli, V; Scrutinio, D; Raimondo, R; Emdin, M; Piepoli, M; Magrì, D; Parati, G; CARAVITA DI TORITTO, Beniamino; Re, F; Cicoira, M; Minà, C; Correale, M; Frigerio, M; Bussotti, M; Oliva, F; Battaia, E; Belardinelli, R; Mezzani, A; Pastormerlo, L; Guazzi, M; Badagliacca, R; Di Lenarda, A; Passino, C; Sciomer, S; Zambon, E; Pacileo, G; Ricci, R; Apostolo, A; Palermo, P; Contini, M; Clemenza, F; Marchese, G; Gargiulo, P; Binno, S; Lombardi, C; Passantino, A; Perrone Filardi, P.. - In: EUROPEAN JOURNAL OF HEART FAILURE. - ISSN 1388-9842. - 20:4(2018), pp. 700-710.
Multiparametric prognostic scores in chronic heart failure with reduced ejection fraction: a long-term comparison.
Paolillo SConceptualization
;Corrà U;Piepoli M;CARAVITA DI TORITTO, BENIAMINO;Pacileo G;Gargiulo P;Perrone Filardi P.Supervision
2018
Abstract
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.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).File | Dimensione | Formato | |
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