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Application of the Seattle Heart Failure Model in Patients on Cardiac Resynchronization Therapy
Author(s) -
PERROTTA LAURA,
RICCIARDI GIUSEPPE,
PIERAGNOLI PAOLO,
CHIOSTRI MARCO,
PONTECORBOLI GIULIA,
DE SANTO TIZIANA,
BELLOCCI FULVIO,
VITULANO NICOLA,
EMDIN MICHELE,
MASCIOLI GIOSUÈ,
RICCERI ILARIA,
PORCIANI MARIA CRISTINA,
MICHELUCCI ANTONIO,
PADELETTI LUIGI
Publication year - 2012
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2011.03258.x
Subject(s) - medicine , cardiac resynchronization therapy , heart failure , clinical endpoint , cardiology , heart transplantation , transplantation , clinical trial , ejection fraction
Background:The Seattle Heart Failure Model (SHFM) is a multimarker risk assessment tool able to predict outcome in heart failure (HF) patients.Aim:To assess whether the SHFM can be used to risk‐stratify HF patients who underwent cardiac resynchronization therapy with (CRT‐D) or without (CRT) an implantable defibrillator.Methods and Results:The SHFM was applied to 342 New York Heart Association class III‐IV patients who received a CRT (23%) or CRT‐D (77%) device. Discrimination and calibration of SHFM were evaluated through c‐statistics and Hosmer‐Lemeshow (H‐L) goodness‐of‐fit test. Primary endpoint was a composite of death from any cause/cardiac transplantation. During a median follow‐up of 24 months (25th–75th percentile [pct]: 12–37 months), 78 of 342 (22.8%) patients died; seven patients underwent urgent transplantation. Median SHFM score for patients with endpoint was 5.8 years (25th–75th pct: 4.25–8.7 years) versus 8.9 years (25th–75th pct: 6.6–11.8 years) for those without (P < 0.001). Discrimination of SHFM was adequate for the endpoint (c‐statistic always ranged around 0.7). The SHFM was a good fit of death from any cause/cardiac transplantation, without significant differences between observed and SHFM‐predicted survival.Conclusion:The SHFM successfully stratifies HF patients on CRT/CRT‐D and can be reliably applied to help clinicians in predicting survival in this clinical setting. (PACE 2012; 35:88–94)