Head‐to‐head comparison of contemporary heart failure risk scores

Codina, Pau; Lupón, Josep; Borrellas, Andrea; Spitaleri, Giosafat; Cediel, Germán; Domingo, Mar; Simpson, Joanne; Levy, Wayne C.; Santiago‐Vacas, Evelyn; Zamora, Elisabet; Buchaca, David; Subirana, Isaac; Santesmases, Javier; Díez‐Quevedo, Crisanto; Troya-Saborido, Maria Isabel; Boldo, M; Altmir, Salvador; Alonso, Núria; González, Beatríz; Rivas, Carmen; Núñez, Julio; McMurray, John J.V.; Bayés‐Genís, Antoni

doi:10.1002/ejhf.2352

Cited by 28 publications

(37 citation statements)

References 17 publications

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“…Second, the investigation did not pursue the MACE (Major Adverse Cardiovascular Events) in older HFmrEF patients. Previous research has verified the role of MAGGIC score in predicting the mortality of HF [ 10 , 11 ]. As the relationship between MAGGIC score and EPC function is revealed by our study, it can be inferred that EPC function may be valuable in predicting the prognosis of HFmrEF.…”

Section: Discussionmentioning

confidence: 84%

“…HFmrEF accounts for 10–24.2% of HF patients [ 6 – 8 ] and has an all-cause mortality 2–3 times higher in the elderly [ 9 ]. The Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) score includes 13 independent predictors of mortality and predicts the 1- and 3-year all-cause mortality of HF [ 10 , 11 ]. Although many studies have examined the characteristics of HFmrEF since it was first named in the 2016 ESC guidelines [ 5 ], the effect of aging on MAGGIC score in HFmrEF patients is still unknown.…”

Section: Introductionmentioning

confidence: 99%

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Aging-Related Endothelial Progenitor Cell Dysfunction and Its Association with IL-17 and IL-23 in HFmrEF Patients

Zeng

Zhang

Cai

et al. 2022

Oxidative Medicine and Cellular Longevity

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Background. Aging is an independent risk factor for heart failure (HF), and endothelial progenitor cell (EPC) function decreases with aging. Here, we further investigated whether age has a detrimental effect on circulating EPC function in HF with mildly reduced ejection fraction (HFmrEF) and its relationship with systemic inflammation. Methods. 58 HFmrEF patients were recruited. The adhesive, migrative, and proliferative activities of circulating EPCs, MAGGIC scores, and plasma interleukin (IL)-17 and IL-23 levels of these patients were assessed. Results. Older patients with HFmrEF had higher MAGGIC scores and lower circulating EPC adhesion, migration, and proliferation than younger patients. The similar tendency was observed in plasma IL-17 and IL-23 levels. The EPC functions were negatively associated with MAGGIC scores and plasma IL-17 or IL-23 levels. Conclusions. In patients with HFmrEF, aging leads to attenuated circulating EPC function, which is correlated with disease severity and systemic inflammation. The present investigation provides some novel insights into the mechanism and intervention targets of HFmrEF.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Aging-Related Endothelial Progenitor Cell Dysfunction and Its Association with IL-17 and IL-23 in HFmrEF Patients

Zeng

Zhang

Cai

et al. 2022

Oxidative Medicine and Cellular Longevity

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“…Physicians are inaccurate in their expected life predictions for terminally ill patients and the error is systematically optimistic, thus affecting the quality of care given to patients near the end of life. None of the contemporary risk scores shows a clear superiority over the others ( 15 ). Barcelona Bio-Heart Failure (BCN-Bio-HF) calculator provides the best discrimination and overall performance but tends to overestimate the risk.…”

Section: Prognosis Assessmentmentioning

confidence: 88%

Modification of Cardiovascular Drugs in Advanced Heart Failure: A Narrative Review

Martínez‐Sellés

Grodzicki

2022

Front. Cardiovasc. Med.

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Advanced heart failure (HF) is a complex entity with a clinical course difficult to predict. However, most patients have a poor prognosis. This document addresses the modification of cardiovascular drugs in patients with advanced HF that are not candidates to heart transplantation or ventricular assist device and are in need of palliative care. The adjustment of cardiovascular drugs is frequently needed in these patients. The shift in emphasis from life-prolonging to symptomatic treatments should be a progressive one. We establish a series of recommendations with the aim of adjusting drugs in these patients, in order to adapt treatment to the needs and wishes of each patient. This is frequently a difficult process for patients and professionals, as drug discontinuing needs to balance treatment benefit with the psychological adaption to having a terminal illness. We encourage the use of validated assessment tools to assess prognosis and to use this information to take clinical decisions regarding drug withdrawal and therapeutic changes. The golden rule is to stop drugs that are harmful or non-essential and to continue the ones that provide symptomatic improvement.

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“…Several prognostic risk models of HF have been developed in recent years, but only a few have been externally validated, and even fewer include cardiac biomarkers known to refine death risk prediction in HF patients. A recent head-to-head comparison of contemporary HF risk scores suggested that natriuretic peptides add value to HF risk stratification tools ( 14 ). The incorporation of biomarkers in HF scores may not only improve discrimination at baseline, but also reflect changes in mortality risk over time.…”

Section: Discussionmentioning

confidence: 99%

Mortality Risk Prediction Dynamics After Heart Failure Treatment Optimization: Repeat Risk Assessment Using Online Risk Calculators

Codina

Zamora

Levy

et al. 2022

Front. Cardiovasc. Med.

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ObjectivesHeart 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.Materials and MethodsOut 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.ResultsA 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).ConclusionMortality 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.

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Head‐to‐head comparison of contemporary heart failure risk scores

Cited by 28 publications

References 17 publications

Aging-Related Endothelial Progenitor Cell Dysfunction and Its Association with IL-17 and IL-23 in HFmrEF Patients

Aging-Related Endothelial Progenitor Cell Dysfunction and Its Association with IL-17 and IL-23 in HFmrEF Patients

Modification of Cardiovascular Drugs in Advanced Heart Failure: A Narrative Review

Mortality Risk Prediction Dynamics After Heart Failure Treatment Optimization: Repeat Risk Assessment Using Online Risk Calculators

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