Risk stratification in patients hospitalized for acute heart failure in Asian population

Hao Chih Chang, Hao Min Cheng, Wei Ming Huang, Ching Wei Lee, Chao Yu Guo, Wen Chung Yu, Chen Huan Chen, Shih Hsien Sung*

*此作品的通信作者

研究成果: Article同行評審

1 引文 斯高帕斯(Scopus)

摘要

Background: The AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score may be suboptimal in predicting long-term mortality in Asian patients with acute heart failure (AHF). We aimed to propose and validate a risk score incorporating easily available echocardiographic parameters to improve risk stratification in Asian patients with AHF. Methods: A total of 3537 patients hospitalized for AHF were enrolled and divided into generation and validation cohorts. Independent predictors of all-cause mortality were identified by Cox regression analysis and scored by hazard ratios to constitute the model. Model performance was validated and evaluated by receiver operating characteristic (ROC) curves and net reclassification improvement (NRI). Results: In the generation cohort of 1775 patients (74.3±13.0 years, 69.9% men), there were 870 deaths (49.0%) during a mean follow-up of 24.7±13.8 months. Age, anemia, estimated glomerular filtration rate <50 ml/min/1.73 m2, hyperuricemia, left ventricular ejection fraction <50% and right ventricular systolic pressure (RVSP) >40 mmHg were independently related to mortality, which constituted "UR-HEARt"(U: uric acid, R: renal function, H: hemoglobin, E: ejection fraction of left ventricle, A: age, Rt: RVSP) score. Model performance was evaluated in the validation cohort (n = 1762), which outperformed AHEAD score by comparison of ROC curves in predicting all-cause mortality (area under curve [AUC] of UR-HEARt vs. AHEAD: 0.66 [95% CI 0.62-0.70] vs. 0.58 [95% CI 0.54-0.62]; p < 0.001), with NRI by 10.9% for all-cause mortality (p < 0.001) and 18.4% for cardiovascular death (p < 0.001). Conclusion: UR-HEARt score, an easily accessible racial-specific risk score with integration of echocardiographic indices, improved risk stratification in Asian patients hospitalized for AHF.

原文English
頁(從 - 到)544-550
頁數7
期刊Journal of the Chinese Medical Association
83
發行號6
DOIs
出版狀態Published - 6月 2020

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