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Multiparametric prognostic scores in chronic heart failure with reduced ejection fraction: a long‐term comparison
Author(s) -
Agostoni Piergiuseppe,
Paolillo Stefania,
Mapelli Massimo,
Gentile Piero,
Salvioni Elisabetta,
Veglia Fabrizio,
Bonomi Alice,
Corrà Ugo,
Lagioia Rocco,
Limongelli Giuseppe,
Sinagra Gianfranco,
Cattadori Gaia,
Scardovi Angela B.,
Metra Marco,
Carubelli Valentina,
Scrutinio Domenico,
Raimondo Rosa,
Emdin Michele,
Piepoli Massimo,
Magrì Damiano,
Parati Gianfranco,
Caravita Sergio,
Re Federica,
Cicoira Mariantonietta,
Minà Chiara,
Correale Michele,
Frigerio Maria,
Bussotti Maurizio,
Oliva Fabrizio,
Battaia Elisa,
Belardinelli Romualdo,
Mezzani Alessandro,
Pastormerlo Luigi,
Guazzi Marco,
Badagliacca Roberto,
Di Lenarda Andrea,
Passino Claudio,
Sciomer Susanna,
Zambon Elena,
Pacileo Giuseppe,
Ricci Roberto,
Apostolo Anna,
Palermo Pietro,
Contini Mauro,
Clemenza Francesco,
Marchese Giovanni,
Gargiulo Paola,
Binno Simone,
Lombardi Carlo,
Passantino Andrea,
Filardi Pasquale Perrone
Publication year - 2018
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.989
Subject(s) - medicine , ejection fraction , heart failure , cardiology , heart transplantation , cohort , receiver operating characteristic , area under the curve , transplantation , clinical endpoint , ventricular assist device , clinical trial
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.