Sudden Cardiac Arrest in Patients With Severe Nonischemic Heart Failure: Risk Stratification With the Heart Failure Survival Score

The authors wanted to investigate whether the heart failure survival score (HFSS) is useful for sudden cardiac arrest (SCA) risk stratification and whether there is a difference with regard to congestive heart failure (CHF) etiology. Data of 712 severe CHF patients (New York Heart Association III/IV 58%/42%, mean age 62±8 years, mean left ventricular ejection fraction 26%±11%) during the period from 1993–2003 were analyzed. The HFSS was calculated using the Aaronson formula. SCA‐free survival was calculated using Kaplan–Meier analysis according to the etiology of CHF: coronary artery disease (CAD) (n=317) vs no CAD (n=395). In regard to SCA risk, the authors found no significant overall difference between patients with or without CAD. Non‐CAD HFSS high‐risk patients had a significantly higher risk for SCA than all the other groups (  P <.001). The HFSS is useful for the detection of a subgroup of non‐CAD severe CHF patients at very high risk for SCA.