ORIGINAL ARTICLE   

Minerva Cardioangiologica 2019 June;67(3):191-9

DOI: 10.23736/S0026-4725.19.04823-0

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Validation of a new score for outcome prediction in patients with heart failure with reduced ejection fraction

Ferdinando LOIACONO ¹ ✉, Gabriele FRAGASSO ², Giliola CALORI ², Luca ALBERTI ², Giovanni MARINOSCI ², Anna SALERNO ², Alberto MARGONATO ²

¹ Department of Cardiovascular Diseases, University of Siena, Siena, Italy; ² Department of Clinical Cardiology, San Raffaele Hospital, Milan, Italy

BACKGROUND: Most models for outcome prediction in heart failure are under-utilized because complex or including non-routine clinical use variables. We aimed to develop a prognostic score for patients with stable heart failure, including only easily obtainable parameters.
METHODS: In 376 outpatients with heart failure (ejection fraction ≤40%), twelve variables were individually correlated with 5-year mortality. Those resulted significant predictors of cardiac and overall mortality were used to obtain a risk score. It was validated on a different sample of 325 patients previously enrolled in other clinical studies, according to tertiles of score.
RESULTS: Previous acute decompensated heart failure, atrial fibrillation, ejection fraction <30%, not-taking beta-blockers, chronic renal failure were the variables included in the final model. There was a significant difference in 5-year cardiac (P=0.004) and all-cause (P=0.003) mortality risk. Compared to the first tertile of the score, the second tertile and the third tertile had an increasing risk for cardiac cause admission (respectively, HR: 2.7; 95% CI: 1.5-4.9 and HR: 3.2; 95% CI: 1.7-6.1) and for heart failure worsening hospitalization (HR:4.3; 95% CI: 1.3-14.5 and HR: 3.8; 95% CI: 1.03-14.1) as well as the third tertile (respectively, HR:3.2; 95% CI: 1.7-6.1 and HR:3.8; 95% CI: 1.03-14.1.).
CONCLUSIONS: Our prognostic model, named OSR HF Risk Score, is a simple, quick, inexpensive tool for predicting patient outcome in 5 years. It might be used as an adjunctive tool in outpatients evaluation alongside more complex scores.

KEY WORDS: Heart failure - Morbidity - Mortality - Prognosis