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Performance of AHEAD Score in an Asian Cohort of Acute Heart Failure With Either Preserved or Reduced Left Ventricular Systolic Function
BACKGROUND: AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score has been related to clinical outcomes of acute heart failure. However, the prognostic value of the AHEAD score in acute heart failure patients with either reduced or preser...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524056/ https://www.ncbi.nlm.nih.gov/pubmed/28473403 http://dx.doi.org/10.1161/JAHA.116.004297 |
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author | Chen, Yu‐Jen Sung, Shih‐Hsien Cheng, Hao‐Min Huang, Wei‐Ming Wu, Chung‐Li Huang, Chi‐Jung Hsu, Pai‐Feng Yeh, Jong‐Shiuan Guo, Chao‐Yu Yu, Wen‐Chung Chen, Chen‐Huan |
author_facet | Chen, Yu‐Jen Sung, Shih‐Hsien Cheng, Hao‐Min Huang, Wei‐Ming Wu, Chung‐Li Huang, Chi‐Jung Hsu, Pai‐Feng Yeh, Jong‐Shiuan Guo, Chao‐Yu Yu, Wen‐Chung Chen, Chen‐Huan |
author_sort | Chen, Yu‐Jen |
collection | PubMed |
description | BACKGROUND: AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score has been related to clinical outcomes of acute heart failure. However, the prognostic value of the AHEAD score in acute heart failure patients with either reduced or preserved left ventricular ejection fraction (HFrEF and HFpEF) remain to be elucidated. METHODS AND RESULTS: The study population consisted of 2143 patients (age 77±12 years, 68% men, 38% HFrEF) hospitalized primarily for acute heart failure with a median follow‐up of 23.75 months. The performance of the AHEAD score (atrial fibrillation, hemoglobin <13 mg/dL for men and 12 mg/dL for women, age >70 years, creatinine >130 μmol/L, and diabetes mellitus) was evaluated by Cox's regression analysis for predicting cardiovascular and all‐cause mortality. The mean AHEAD scores were 2.7±1.2 in the total study population, 2.6±1.3 in the HFrEF group, and 2.7±1.1 in the HFpEF group. After accounting for sex, sodium, uric acid, and medications, the AHEAD score remained significantly associated with all‐cause and cardiovascular mortality (hazard ratio and 95% CI: 1.49, 1.38–1.60 and 1.48, 1.33–1.64), respectively. The associations of AHEAD score with mortality remained significant in the subgroups of HFrEF (1.63, 1.47–1.82) and HFpEF (1.34, 1.22–1.48). Moreover, when we calculated a new AHEAD‐U score by considering uric acid (>8.6 mg/dL) in addition to the AHEAD score, the net reclassification was improved by 19.7% and 20.1% for predicting all‐cause and cardiovascular mortality, respectively. CONCLUSIONS: The AHEAD score was useful in predicting long‐term mortality in the Asian acute heart failure cohort with either HFrEF or HFpEF. The new AHEAD‐U score may further improve risk stratification. |
format | Online Article Text |
id | pubmed-5524056 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-55240562017-08-02 Performance of AHEAD Score in an Asian Cohort of Acute Heart Failure With Either Preserved or Reduced Left Ventricular Systolic Function Chen, Yu‐Jen Sung, Shih‐Hsien Cheng, Hao‐Min Huang, Wei‐Ming Wu, Chung‐Li Huang, Chi‐Jung Hsu, Pai‐Feng Yeh, Jong‐Shiuan Guo, Chao‐Yu Yu, Wen‐Chung Chen, Chen‐Huan J Am Heart Assoc Original Research BACKGROUND: AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score has been related to clinical outcomes of acute heart failure. However, the prognostic value of the AHEAD score in acute heart failure patients with either reduced or preserved left ventricular ejection fraction (HFrEF and HFpEF) remain to be elucidated. METHODS AND RESULTS: The study population consisted of 2143 patients (age 77±12 years, 68% men, 38% HFrEF) hospitalized primarily for acute heart failure with a median follow‐up of 23.75 months. The performance of the AHEAD score (atrial fibrillation, hemoglobin <13 mg/dL for men and 12 mg/dL for women, age >70 years, creatinine >130 μmol/L, and diabetes mellitus) was evaluated by Cox's regression analysis for predicting cardiovascular and all‐cause mortality. The mean AHEAD scores were 2.7±1.2 in the total study population, 2.6±1.3 in the HFrEF group, and 2.7±1.1 in the HFpEF group. After accounting for sex, sodium, uric acid, and medications, the AHEAD score remained significantly associated with all‐cause and cardiovascular mortality (hazard ratio and 95% CI: 1.49, 1.38–1.60 and 1.48, 1.33–1.64), respectively. The associations of AHEAD score with mortality remained significant in the subgroups of HFrEF (1.63, 1.47–1.82) and HFpEF (1.34, 1.22–1.48). Moreover, when we calculated a new AHEAD‐U score by considering uric acid (>8.6 mg/dL) in addition to the AHEAD score, the net reclassification was improved by 19.7% and 20.1% for predicting all‐cause and cardiovascular mortality, respectively. CONCLUSIONS: The AHEAD score was useful in predicting long‐term mortality in the Asian acute heart failure cohort with either HFrEF or HFpEF. The new AHEAD‐U score may further improve risk stratification. John Wiley and Sons Inc. 2017-05-04 /pmc/articles/PMC5524056/ /pubmed/28473403 http://dx.doi.org/10.1161/JAHA.116.004297 Text en © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Chen, Yu‐Jen Sung, Shih‐Hsien Cheng, Hao‐Min Huang, Wei‐Ming Wu, Chung‐Li Huang, Chi‐Jung Hsu, Pai‐Feng Yeh, Jong‐Shiuan Guo, Chao‐Yu Yu, Wen‐Chung Chen, Chen‐Huan Performance of AHEAD Score in an Asian Cohort of Acute Heart Failure With Either Preserved or Reduced Left Ventricular Systolic Function |
title | Performance of AHEAD Score in an Asian Cohort of Acute Heart Failure With Either Preserved or Reduced Left Ventricular Systolic Function |
title_full | Performance of AHEAD Score in an Asian Cohort of Acute Heart Failure With Either Preserved or Reduced Left Ventricular Systolic Function |
title_fullStr | Performance of AHEAD Score in an Asian Cohort of Acute Heart Failure With Either Preserved or Reduced Left Ventricular Systolic Function |
title_full_unstemmed | Performance of AHEAD Score in an Asian Cohort of Acute Heart Failure With Either Preserved or Reduced Left Ventricular Systolic Function |
title_short | Performance of AHEAD Score in an Asian Cohort of Acute Heart Failure With Either Preserved or Reduced Left Ventricular Systolic Function |
title_sort | performance of ahead score in an asian cohort of acute heart failure with either preserved or reduced left ventricular systolic function |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524056/ https://www.ncbi.nlm.nih.gov/pubmed/28473403 http://dx.doi.org/10.1161/JAHA.116.004297 |
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