Heart failure risk scores in advanced heart failure patients: insights from the LEVO-D registry

Aims: The prevalence of advanced heart failure (HF) is increasing due to the growing number of patients with HF and their better treatment and survival. There is a scarcity of data on the accuracy of HF web-based risk scores in this selected population. This study aimed to assess mortality predictio...

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Detalles Bibliográficos
Autores: Vaqueriza-Cubillo, David, Codina, Pau, Dobarro, David, Juan-Bagudá, Javier de, Frutos, Fernando de, Lupón, Josep, Bayes-Genis, Antoni, González-Costello, José, Donoso-Trenado, Víctor, Solé-González, Eduard, Moliner-Abós, Carlos, García-Pinilla, Jose Manuel, Lopez-Fernandez, Silvia, Ruiz-Bustillo, Sonia, Diez López, Carles, Castrodeza, Javier, Méndez-Fernández, Ana B., Cobo-Marcos, Marta, Tobar, Javier, Sagasti-Aboitiz, Igor, Rodriguez, Miguel, Escolar, Vanessa, Abecia, Ana, Gómez-Otero, Inés, Pastor, Francisco, Marzoa-Rivas, Raquel, González-Babarro, Eva, Melendo Viu, Maria
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/220173
Acceso en línea:https://hdl.handle.net/2445/220173
Access Level:acceso abierto
Palabra clave:Insuficiència cardíaca
Factors de risc en les malalties
Mortalitat
Heart failure
Risk factors in diseases
Mortality
Descripción
Sumario:Aims: The prevalence of advanced heart failure (HF) is increasing due to the growing number of patients with HF and their better treatment and survival. There is a scarcity of data on the accuracy of HF web-based risk scores in this selected population. This study aimed to assess mortality prediction performance of the Meta-Analysis Global Group in Chronic HF (MAGGIC-HF) risk score and the model of the Barcelona Bio-HF Risk Calculator (BCN-Bio-HF) containing N terminal pro brain natriuretic peptide in HF patients receiving intermittent inotropic support with levosimendan as destination therapy. Methods and results: Four hundred and three advanced HF patients from 23 tertiary hospitals in Spain receiving intermittent inotropic support with levosimendan as destination therapy were included. Discrimination for all-cause mortality was compared by area under the curve (AUC) and Harrell's C-statistic at 1 year. Calibration was assessed by calibration plots comparing observed versus expected events based on estimated risk by each calculator. The included patients were predominantly men, aged 71.5 [interquartile range 64-78] years, with reduced left ventricular ejection fraction (27.5 ± 9.4%); ischaemic heart disease was the most prevalent aetiology (52.5%). Death rate at 1 year was 26.8%, while the predicted 1-year mortality by BCN-Bio-HF and MAGGIC-HF was 17.0% and 22.1%, respectively. BCN-Bio-HF AUC was 0.66 (Harrell's C-statistic 0.64), and MAGGIC-HF AUC was 0.62 (Harrell's C-statistic 0.61). Conclusions: The two evaluated risk scores showed suboptimal discrimination and calibration with an underestimation of risk in advanced HF patients receiving levosimendan as destination therapy. There is a need for specific scores for advanced HF.

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