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Mortality Risk Prediction Dynamics After Heart Failure Treatment Optimization: Repeat Risk Assessment Using Online Risk Calculators
OBJECTIVES: 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. MATERIALS AND METHODS: Out of 1,032 consecutive H...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039357/ https://www.ncbi.nlm.nih.gov/pubmed/35498033 http://dx.doi.org/10.3389/fcvm.2022.836451 |
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author | Codina, Pau Zamora, Elisabet Levy, Wayne C. Revuelta-López, Elena Borrellas, Andrea Spitaleri, Giosafat Cediel, Germán Ruiz-Cueto, María Cañedo, Elena Santiago-Vacas, Evelyn Domingo, Mar Buchaca, David Subirana, Isaac Santesmases, Javier de la Espriella, Rafael Nuñez, Julio Lupón, Josep Bayes-Genis, Antoni |
author_facet | Codina, Pau Zamora, Elisabet Levy, Wayne C. Revuelta-López, Elena Borrellas, Andrea Spitaleri, Giosafat Cediel, Germán Ruiz-Cueto, María Cañedo, Elena Santiago-Vacas, Evelyn Domingo, Mar Buchaca, David Subirana, Isaac Santesmases, Javier de la Espriella, Rafael Nuñez, Julio Lupón, Josep Bayes-Genis, Antoni |
author_sort | Codina, Pau |
collection | PubMed |
description | OBJECTIVES: 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. MATERIALS AND METHODS: 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. RESULTS: 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). CONCLUSION: 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. |
format | Online Article Text |
id | pubmed-9039357 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-90393572022-04-27 Mortality Risk Prediction Dynamics After Heart Failure Treatment Optimization: Repeat Risk Assessment Using Online Risk Calculators Codina, Pau Zamora, Elisabet Levy, Wayne C. Revuelta-López, Elena Borrellas, Andrea Spitaleri, Giosafat Cediel, Germán Ruiz-Cueto, María Cañedo, Elena Santiago-Vacas, Evelyn Domingo, Mar Buchaca, David Subirana, Isaac Santesmases, Javier de la Espriella, Rafael Nuñez, Julio Lupón, Josep Bayes-Genis, Antoni Front Cardiovasc Med Cardiovascular Medicine OBJECTIVES: 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. MATERIALS AND METHODS: 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. RESULTS: 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). CONCLUSION: 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. Frontiers Media S.A. 2022-04-12 /pmc/articles/PMC9039357/ /pubmed/35498033 http://dx.doi.org/10.3389/fcvm.2022.836451 Text en Copyright © 2022 Codina, Zamora, Levy, Revuelta-López, Borrellas, Spitaleri, Cediel, Ruiz-Cueto, Cañedo, Santiago-Vacas, Domingo, Buchaca, Subirana, Santesmases, Espriella, Nuñez, Lupón and Bayes-Genis. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Codina, Pau Zamora, Elisabet Levy, Wayne C. Revuelta-López, Elena Borrellas, Andrea Spitaleri, Giosafat Cediel, Germán Ruiz-Cueto, María Cañedo, Elena Santiago-Vacas, Evelyn Domingo, Mar Buchaca, David Subirana, Isaac Santesmases, Javier de la Espriella, Rafael Nuñez, Julio Lupón, Josep Bayes-Genis, Antoni Mortality Risk Prediction Dynamics After Heart Failure Treatment Optimization: Repeat Risk Assessment Using Online Risk Calculators |
title | Mortality Risk Prediction Dynamics After Heart Failure Treatment Optimization: Repeat Risk Assessment Using Online Risk Calculators |
title_full | Mortality Risk Prediction Dynamics After Heart Failure Treatment Optimization: Repeat Risk Assessment Using Online Risk Calculators |
title_fullStr | Mortality Risk Prediction Dynamics After Heart Failure Treatment Optimization: Repeat Risk Assessment Using Online Risk Calculators |
title_full_unstemmed | Mortality Risk Prediction Dynamics After Heart Failure Treatment Optimization: Repeat Risk Assessment Using Online Risk Calculators |
title_short | Mortality Risk Prediction Dynamics After Heart Failure Treatment Optimization: Repeat Risk Assessment Using Online Risk Calculators |
title_sort | mortality risk prediction dynamics after heart failure treatment optimization: repeat risk assessment using online risk calculators |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039357/ https://www.ncbi.nlm.nih.gov/pubmed/35498033 http://dx.doi.org/10.3389/fcvm.2022.836451 |
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