医学
内科学
射血分数
心肌梗塞
心力衰竭
红细胞分布宽度
逻辑回归
临床终点
回顾性队列研究
优势比
队列
心脏病学
弗雷明翰风险评分
前瞻性队列研究
临床试验
疾病
作者
Αndrew Xanthopoulos,Grigorios Giamouzis,Konstantinos Tryposkiadis,E Paraskevopoulou,Patrina Paraskevopoulou,Georgios Karagiannis,S Patsilinakos,John Parissis,Dimitrios Farmakis,Javed Butler,John Skoularigis,Filippos Triposkiadis
标识
DOI:10.1016/j.ijcard.2016.12.131
摘要
Introduction The use of many acute heart failure (AHF) risk scores is cumbersome. We therefore developed a simple AHF risk score (AHFRS) for early risk stratification. Methods The study consisted of a prospective derivation cohort (PDC; N = 104; age, 77[21] years; LVEF (%), 35[29]) and a retrospective validation cohort (RVC; N = 141; age, 76[15] years; LVEF (%), 35[25]). Clinical, echocardiography and laboratory assessment was performed at admission. The study end-point was death from any cause or HF-rehospitalization at 1 year. Results In the PDC 46 (44.2%) patients experienced the end-point. Independent prognostic factors of outcome were hypertension (HTN) history, myocardial infarction (MI) history, and admission red cell distribution width (RDW). Multivariate logistic regression indicated 8-, 4-, and 3-times higher odds ratio for development of study end-point in patients without a HTN history, with MI history, and RDW ≥ 15% (median) respectively. Thus in AHFRS, 2 points were assigned for absence of HTN history, 1 point for presence of MI history, and 1 point for RDW values ≥15% (0 best possible, whereas 4 worst possible score). The AHFRS identified patients who developed the end-point in the PDC with an area under the ROC curve (AUC) of 0.80 [95% C.I.: (0.71, 0.87)] denoting a high discriminative ability. These findings were confirmed in the RVC, in which the endpoint occurred in 52 (36.9%) patients and the AUC for the AHFRS was 0.82 [95% C.I.: (0.73, 0.89)]. Conclusions AHFRS is easily obtained at admission and accurately risk stratifies AHF patients.
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