Jindrich Spinar1, Jiri Jarkovsky2, Lenka Spinarova3, Alexandre Mebazaa4, Etienne Gayat4, Jiri Vitovec3, Ales Linhart5, Petr Widimsky6, Roman Miklik7, Kamil Zeman8, Jan Belohlavek5, Filip Malek9, Marian Felsoci1, Jiri Kettner10, Petr Ostadal9, Cestmir Cihalik11, Jan Vaclavik11, Miloš Taborsky11, Ladislav Dusek2, Simona Littnerova2, Jiri Parenica12. 1. Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic. 2. Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic. 3. Medical Faculty, Masaryk University, Brno, Czech Republic; First Department of Cardiovascular Internal Medicine, University Hospital St Anne's, Brno, Czech Republic. 4. Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisiere University Hospital, Paris, France; UMR-S 942, Inserm, Paris, France. 5. 2nd Department of Cardiovascular Internal Medicine, First Medical Faculty, Charles University, Prague and General Teaching Hospital of Prague, Prague, Czech Republic. 6. Kralovske Vinohrady University Hospital and the 3rd Faculty of Medicine, Charles University, Prague, Czech Republic. 7. Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic. 8. Department of Internal Medicine, Hospital Frydek-Mistek, Frydek-Mistek, Czech Republic. 9. Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic. 10. Department of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic. 11. Department of Internal Medicine, University Hospital Olomouc, Olomouc, Czech Republic. 12. Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic. Electronic address: jiri.parenica@atlas.cz.
Abstract
BACKGROUND: The role of co-morbidities in the prognosis of patients hospitalized for AHF was examined using the AHEAD (A--atrial fibrillation, H--haemoglobin<130 g/l for men and 120 g/l for women (anaemia), E--elderly (age>70years), A--abnormal renal parameters (creatinine>130 μmol/l), D--diabetes mellitus) scoring system. METHODS: AHEAD--multicentre prospective Czech registry of AHF patients; GREAT registry--international cohort of AHF patients. Data from 5846 consecutive patients hospitalized for AHF (AHEAD registry; derivation cohort) were analysed to build the AHEAD score. Each risk factor of the AHEAD score was counted as 1 point. The model was validated externally using an international cohort of similar patients in the GREAT registry (6315). RESULTS: Main outcome was one year all-cause mortality. The mean age of patients was 72±12 years, with 61.6% of patients aged >70 years; 43.4% were women. Atrial fibrillation was present in 30.7%, anaemia in 38.2%, creatinine>130 mmol/l (abnormal renal parameters) in 30.1%, and diabetes mellitus in 44.0%. The mean AHEAD score was 2.1. In patients with AHEAD scores of 0-5, the one-year mortality rates were 13.6%, 23.4%, 32.0%, 41.1%, 47.7%, and 58.2%, respectively (p<0.001), and the 90 month mortality rates were 35.1%, 57.3%, 73.5%, 84.8%, 88.0%, and 91.7%, respectively (p<0.001). CONCLUSION: The AHEAD is a simple scoring system based on the analysis of co-morbidities for the estimation of the short and long term prognosis of patients hospitalized for AHF.
BACKGROUND: The role of co-morbidities in the prognosis of patients hospitalized for AHF was examined using the AHEAD (A--atrial fibrillation, H--haemoglobin<130 g/l for men and 120 g/l for women (anaemia), E--elderly (age>70years), A--abnormal renal parameters (creatinine>130 μmol/l), D--diabetes mellitus) scoring system. METHODS: AHEAD--multicentre prospective Czech registry of AHF patients; GREAT registry--international cohort of AHF patients. Data from 5846 consecutive patients hospitalized for AHF (AHEAD registry; derivation cohort) were analysed to build the AHEAD score. Each risk factor of the AHEAD score was counted as 1 point. The model was validated externally using an international cohort of similar patients in the GREAT registry (6315). RESULTS: Main outcome was one year all-cause mortality. The mean age of patients was 72±12 years, with 61.6% of patients aged >70 years; 43.4% were women. Atrial fibrillation was present in 30.7%, anaemia in 38.2%, creatinine>130 mmol/l (abnormal renal parameters) in 30.1%, and diabetes mellitus in 44.0%. The mean AHEAD score was 2.1. In patients with AHEAD scores of 0-5, the one-year mortality rates were 13.6%, 23.4%, 32.0%, 41.1%, 47.7%, and 58.2%, respectively (p<0.001), and the 90 month mortality rates were 35.1%, 57.3%, 73.5%, 84.8%, 88.0%, and 91.7%, respectively (p<0.001). CONCLUSION: The AHEAD is a simple scoring system based on the analysis of co-morbidities for the estimation of the short and long term prognosis of patients hospitalized for AHF.
Authors: Jindrich Spinar; Jiri Jarkovsky; Lenka Spinarova; Jiri Vitovec; Ales Linhart; Petr Widimsky; Roman Miklik; Kamil Zeman; Jan Belohlavek; Filip Malek; Cestmir Cihalik; Jiri Spac; Marian Felsoci; Petr Ostadal; Ladislav Dusek; Jiri Kettner; Jan Vaclavik; Simona Littnerova; Zdeněk Monhart; Josef Malek; Jiri Parenica Journal: ESC Heart Fail Date: 2016-09-17
Authors: Marie Pavlusova; Jiri Jarkovsky; Klara Benesova; Jiri Vitovec; Ales Linhart; Petr Widimsky; Lenka Spinarova; Kamil Zeman; Jan Belohlavek; Filip Malek; Marian Felsoci; Jiri Kettner; Petr Ostadal; Cestmir Cihalik; Jiri Spac; Hikmet Al-Hiti; Marian Fedorco; Richard Fojt; Andreas Kruger; Josef Malek; Tereza Mikusova; Zdenek Monhart; Stanislava Bohacova; Lidka Pohludkova; Filip Rohac; Jan Vaclavik; Dagmar Vondrakova; Klaudia Vyskocilova; Miroslav Bambuch; Gabriela Dostalova; Stepan Havranek; Ivana Svobodová; Ladislav Dusek; Jindrich Spinar; Roman Miklik; Jiri Parenica Journal: Clin Cardiol Date: 2019-05-29 Impact factor: 2.882