Mortality Risk Prediction Dynamics After Heart Failure Treatment Optimization : Repeat Risk Assessment Using Online Risk Calculators
Codina, Pau (Universitat Autònoma de Barcelona. Facultat de Medicina)
Zamora, Elisabet (Universitat Autònoma de Barcelona. Facultat de Medicina)
Levy, Wayne C. (University of Washington)
Revuelta-López, Elena (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Borrellas, Andrea (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Spitaleri, Giosafat (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Cediel, Germán (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ruiz Cueto, María (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Cañedo, Elena (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Santiago Vacas, Evelyn (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Domingo, Mar (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Buchaca, David (Barcelona Supercomputing Center)
Subirana, Isaac (Institut Hospital del Mar d'Investigacions Mèdiques)
Santesmases, Javier (Universitat Autònoma de Barcelona. Departament de Medicina)
De la Espriella, Rafael (Hospital Clínic Universitari (València))
Núñez, Julio (Hospital Clínic Universitari (València))
Lupón, Josep (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bayés-Genís, Antoni (Universitat Autònoma de Barcelona. Departament de Medicina)

Fecha:	2022
Resumen:	Heart failure (HF) management has significantly improved over the past two decades, leading to better survival. This study aimed to assess changes in predicted mortality risk after 12 months of management in a multidisciplinary HF clinic. Out of 1,032 consecutive HF outpatients admitted from March-2012 to November-2018, 357 completed the 12-months follow-up and had N-terminal pro-B-type natriuretic peptide (NTproBNP), high sensitivity troponin T (hs-TnT), and interleukin-1 receptor-like-1 (known as ST2) measurements available both at baseline and follow-up. Three contemporary risk scores were used: MAGGIC-HF, Seattle HF Model (SHFM), and the Barcelona Bio-HF (BCN Bio-HF) calculator, which incorporates the three above mentioned biomarkers. The predicted risk of all-cause death at 1 and 3 years was calculated at baseline and re-evaluated after 12 months. A significant decline in predicted 1-and 3-year mortality risk was observed at 12 months: MAGGIC ~16%, SHFM ~22% and BCN Bio-HF ~15%. In the HF with reduced ejection fraction (HFrEF) subgroup guideline-directed medical therapy led to a complete normalization of left ventricular ejection fraction (≥50%) in almost a third of the patients and to a partial normalization (41-49%) in 30% of them. Repeated risk assessment after 12 months with SHFM and BCN Bio-HF provided adequate discrimination for all-cause 3-year mortality (C-Index: MAGGIC-HF 0. 762, SHFM 0. 781 and BCN Bio-HF 0. 791). Mortality risk declines in patients with HF managed for 12 months in a multidisciplinary HF clinic. Repeating the mortality risk assessment after optimizing the HF treatment is recommended, particularly in the HFrEF subgroup.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Heart failure ; Mortality ; Risk models ; Risk prediction ; Prognosis
Publicado en:	Frontiers in Cardiovascular Medicine, Vol. 9 (April 2022) , ISSN 2297-055X

DOI: 10.3389/fcvm.2022.836451
PMID: 35498033

10 p, 2.1 MB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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