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Performance of Mortality Risk Scores in Advanced Heart Failure patients: A Retrospective Cohort Study
Session:
SESSÃO DE POSTERS 21 - IC E PROGNÓSTICO
Speaker:
Francisco Salvaterra
Congress:
CPC 2025
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.2 Chronic Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Cartazes
FP Number:
---
Authors:
Francisco Salvaterra; Catarina Gregório; João Fernandes Pedro; Fátima Salazar; Ana Francês; Rafael Santos; Joana Rigueira; Doroteia Silva; Nuno Lousada; Fausto J. Pinto; Dulce Brito; João R. Agostinho
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong><span style="font-size:12.0pt">Introduction</span></strong><span style="font-size:12.0pt">: Heart failure (HF) prognostic scores to predict mortality risk are widely used, however their predictive accuracy may be reduced in certain subsets of patients. Patients with advanced HF who are receiving intermittent inotropic therapy were not used to derive these score models, so their accuracy to predict mortality in this population is unknown. </span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong><span style="font-size:12.0pt">Purpose</span></strong><span style="font-size:12.0pt">: This study aims to evaluate the performance of three commonly used heart failure prognostic scores for predicting 1-year mortality in a population of advanced HF patients receiving intermittent inotropic therapy. </span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong><span style="font-size:12.0pt">Methods</span></strong><span style="font-size:12.0pt">: Retrospective, single-centre study of patients with advanced HF receiving intermittent levosimendan infusions. Three mortality risk scores - Seattle HF Model, <span style="background-color:white"><span style="color:#1b1b1b">BCN Bio-HF Calculator and MAGGIC Risk Calculator - were used to calculate the predict 1-year mortality. The predictive accuracy of each score was evaluated using the area under the curve (AUC) derived from receiver operating characteristic (ROC) curve analysis using the observed mortality. AUCs were compared using the DeLong method.</span></span></span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong><span style="font-size:12.0pt">Results</span></strong><span style="font-size:12.0pt">: Among a cohort of 34 patients with advanced HF receiving intermittent levosimendan, with a median age of 68 (IQR 63–73) years, a median left ventricle ejection fraction of 24% (IQR 16–27%), the majority in NYHA Class III or IV (97.1%), the observed 1-year mortality rate was 26.5%. All the three prognostic scores showed insufficient predictive accuracy for 1-year mortality. The Seattle HF Model demonstrated the highest predictive accuracy with an AUC of 0.618 (95% CI: 0.395-0.841; p=0.301) – Figure 1. The AUCs for the BCN-Bio HF Calculator and the MAGGIC Risk Calculator were both 0.419 (95% CI: 0.226-0.671; p=0.652) – Figure 1. No statistically significant difference was found between the AUCs of each of the three scores as assessed by the DeLong test, supporting the fact that the prognostic ability of each score was very limited.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong><span style="font-size:12.0pt">Conclusions</span></strong><span style="font-size:12.0pt">: The findings of this study suggest that current scoring systems may not fully capture the whole clinical spectrum of advanced heart failure patients under supportive therapies that are still not fully proven. Future studies should explore the development of more tailored prognostic tools</span></span></span></p>
Slides
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