Piergiuseppe Agostoni1,2, Stefania Paolillo3, Massimo Mapelli1, Piero Gentile4, Elisabetta Salvioni1, Fabrizio Veglia1, Alice Bonomi1, Ugo Corrà5, Rocco Lagioia6, Giuseppe Limongelli7, Gianfranco Sinagra4, Gaia Cattadori8, Angela B Scardovi9, Marco Metra10, Valentina Carubelli10, Domenico Scrutinio6, Rosa Raimondo11, Michele Emdin12,13, Massimo Piepoli14, Damiano Magrì15, Gianfranco Parati16,17, Sergio Caravita17, Federica Re18, Mariantonietta Cicoira19, Chiara Minà20, Michele Correale21, Maria Frigerio22, Maurizio Bussotti23, Fabrizio Oliva24, Elisa Battaia24, Romualdo Belardinelli25, Alessandro Mezzani5, Luigi Pastormerlo12, Marco Guazzi26, Roberto Badagliacca27, Andrea Di Lenarda28, Claudio Passino12,13, Susanna Sciomer27, Elena Zambon4, Giuseppe Pacileo7, Roberto Ricci9, Anna Apostolo1, Pietro Palermo1, Mauro Contini1, Francesco Clemenza19, Giovanni Marchese22, Paola Gargiulo3, Simone Binno14, Carlo Lombardi10, Andrea Passantino6, Pasquale Perrone Filardi29. 1. Centro Cardiologico Monzino, IRCCS, Milan, Italy. 2. Cardiovascular Section, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. 3. SDN IRCCS, Naples, Italy. 4. Cardiovascular Department, Ospedali Riuniti and University of Trieste, Trieste, Italy. 5. Division of Cardiac Rehabilitation, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Veruno, Veruno, Italy. 6. Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Cassano Murge, Bari, Italy. 7. Cardiology SUN, Monaldi Hospital (Azienda dei Colli), Second University of Naples, Naples, Italy. 8. Cardiac Rehabilitation Unit, Multimedica IRCCS, Milan, Italy. 9. Cardiology Division, Santo Spirito Hospital, Rome, Italy. 10. Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy. 11. Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Tradate, Tradate, Italy. 12. Gabriele Monasterio Foundation, CNR-Regione Toscana, Pisa, Italy. 13. Life Science Institute, Scuola Superiore Sant'Anna, Pisa, Italy. 14. Heart Failure Unit, Cardiac Department, Guglielmo da Saliceto Hospital, Piacenza, Italy. 15. Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy. 16. Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy. 17. Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano, Milan, Italy. 18. Cardiology Division, Cardiac Arrhythmia Center and Cardiomyopathies Unit, San Camillo-Forlanini Hospital, Rome, Italy. 19. Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy. 20. Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETT, Palermo, Italy. 21. Department of Cardiology, University of Foggia, Foggia, Italy. 22. De Gasperis Cardiocenter, Niguarda Ca' Granda Hospital, Milan, Italy. 23. Cardiac Rehabilitation Unit, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Milan, Milan, Italy. 24. Department of Cardiology, S. Chiara Hospital, Trento, Italy. 25. Cardiac Rehabilitation, Azienda Ospedali Riuniti, Ancona, Italy. 26. Cardiology University Department, Heart Failure Unit and Cardiopulmonary Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. 27. Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy. 28. Cardiovascular Center, Health Authority n. 1 and University of Trieste, Trieste, Italy. 29. Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy.
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.
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.
Authors: Scott C Silvestry; Claudius Mahr; Mark S Slaughter; Wayne C Levy; Richard K Cheng; Damian M May; Eleni Ismyrloglou; Stelios I Tsintzos; Edward Tuttle; Keziah Cook; Erica Birk; Aparna Gomes; Sophia Graham; William G Cotts Journal: ASAIO J Date: 2020-08 Impact factor: 2.872
Authors: Piotr Ponikowski; Ilaria Spoletini; Andrew J S Coats; Massimo F Piepoli; Giuseppe M C Rosano Journal: Eur Heart J Suppl Date: 2019-12-31 Impact factor: 1.803
Authors: Elisabetta Salvioni; Ugo Corrà; Massimo Piepoli; Sara Rovai; Michele Correale; Stefania Paolillo; Mario Pasquali; Damiano Magrì; Giuseppe Vitale; Laura Fusini; Massimo Mapelli; Carlo Vignati; Rocco Lagioia; Rosa Raimondo; Gianfranco Sinagra; Federico Boggio; Lorenzo Cangiano; Giovanna Gallo; Alessandra Magini; Mauro Contini; Pietro Palermo; Anna Apostolo; Beatrice Pezzuto; Alice Bonomi; Angela B Scardovi; Pasquale Perrone Filardi; Giuseppe Limongelli; Marco Metra; Domenico Scrutinio; Michele Emdin; Lucrezia Piccioli; Carlo Lombardi; Gaia Cattadori; Gianfranco Parati; Sergio Caravita; Federica Re; Mariantonietta Cicoira; Maria Frigerio; Francesco Clemenza; Maurizio Bussotti; Elisa Battaia; Marco Guazzi; Francesco Bandera; Roberto Badagliacca; Andrea Di Lenarda; Giuseppe Pacileo; Claudio Passino; Susanna Sciomer; Giuseppe Ambrosio; Piergiuseppe Agostoni Journal: ESC Heart Fail Date: 2020-01-01