A Xanthopoulos1, G Giamouzis1, K Tryposkiadis2, E Paraskevopoulou3, P Paraskevopoulou4, G Karagiannis5, S Patsilinakos3, J Parissis6, D Farmakis6, J Butler7, J Skoularigis1, F Triposkiadis8. 1. University General Hospital of Larissa, Department of Cardiology, Larissa, Greece. 2. Independent Biostatistician, Athens, Greece. 3. Konstantopoulio General Hospital, Cardiology Department, Athens, Greece. 4. Konstantopoulio General Hospital, Hematology Lab, Athens, Greece. 5. Harefield Hospital, London, United Kingdom. 6. Department of Cardiology, Athens University Hospital Attikon, Athens, Greece. 7. Division of Cardiology, Stony Brook University, Stony Brook, New York, United States. 8. University General Hospital of Larissa, Department of Cardiology, Larissa, Greece. Electronic address: ftriposkiadis@gmail.com.
Abstract
INTRODUCTION: The use of many acute heart failure (AHF) risk scores is cumbersome. We therefore developed a simple AHF risk score (AHFRS) for early risk stratification. METHODS: The study consisted of a prospective derivation cohort (PDC; N=104; age, 77[21] years; LVEF (%), 35[29]) and a retrospective validation cohort (RVC; N=141; age, 76[15] years; LVEF (%), 35[25]). Clinical, echocardiography and laboratory assessment was performed at admission. The study end-point was death from any cause or HF-rehospitalization at 1year. RESULTS: In the PDC 46 (44.2%) patients experienced the end-point. Independent prognostic factors of outcome were hypertension (HTN) history, myocardial infarction (MI) history, and admission red cell distribution width (RDW). Multivariate logistic regression indicated 8-, 4-, and 3-times higher odds ratio for development of study end-point in patients without a HTN history, with MI history, and RDW≥15% (median) respectively. Thus in AHFRS, 2 points were assigned for absence of HTN history, 1 point for presence of MI history, and 1 point for RDW values ≥15% (0 best possible, whereas 4 worst possible score). The AHFRS identified patients who developed the end-point in the PDC with an area under the ROC curve (AUC) of 0.80 [95% C.I.: (0.71, 0.87)] denoting a high discriminative ability. These findings were confirmed in the RVC, in which the endpoint occurred in 52 (36.9%) patients and the AUC for the AHFRS was 0.82 [95% C.I.: (0.73, 0.89)]. CONCLUSIONS: AHFRS is easily obtained at admission and accurately risk stratifies AHF patients.
INTRODUCTION: The use of many acute heart failure (AHF) risk scores is cumbersome. We therefore developed a simple AHF risk score (AHFRS) for early risk stratification. METHODS: The study consisted of a prospective derivation cohort (PDC; N=104; age, 77[21] years; LVEF (%), 35[29]) and a retrospective validation cohort (RVC; N=141; age, 76[15] years; LVEF (%), 35[25]). Clinical, echocardiography and laboratory assessment was performed at admission. The study end-point was death from any cause or HF-rehospitalization at 1year. RESULTS: In the PDC 46 (44.2%) patients experienced the end-point. Independent prognostic factors of outcome were hypertension (HTN) history, myocardial infarction (MI) history, and admission red cell distribution width (RDW). Multivariate logistic regression indicated 8-, 4-, and 3-times higher odds ratio for development of study end-point in patients without a HTN history, with MI history, and RDW≥15% (median) respectively. Thus in AHFRS, 2 points were assigned for absence of HTN history, 1 point for presence of MI history, and 1 point for RDW values ≥15% (0 best possible, whereas 4 worst possible score). The AHFRS identified patients who developed the end-point in the PDC with an area under the ROC curve (AUC) of 0.80 [95% C.I.: (0.71, 0.87)] denoting a high discriminative ability. These findings were confirmed in the RVC, in which the endpoint occurred in 52 (36.9%) patients and the AUC for the AHFRS was 0.82 [95% C.I.: (0.73, 0.89)]. CONCLUSIONS: AHFRS is easily obtained at admission and accurately risk stratifies AHF patients.
Authors: Roger Hullin; Nicolas Barras; Tamila Abdurashidova; Pierre Monney; Julien Regamey Journal: Intern Emerg Med Date: 2018-12-13 Impact factor: 3.397
Authors: Gianni Turcato; Gianfranco Cervellin; Antonio Bonora; Danieli Prati; Elisabetta Zorzi; Giorgio Ricci; Gian Luca Salvagno; Antonio Maccagnani; Giuseppe Lippi Journal: J Med Biochem Date: 2018-07-01 Impact factor: 3.402