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A. Basics
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01. History of Cardiology
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06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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32. Cardiovascular Nursing
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Get With The Guidelines – Heart Failure risk score: short and long term preditive value
Session:
Painel 2- Insuficiencia cardiaca 4
Speaker:
Joana Laranjeira Correia
Congress:
CPC 2020
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.2 Chronic Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Joana Laranjeira Correia; João Miguel Santos; Inês Pires; Luísa Gonçalves; Hugo Da Silva Antunes; António Costa; José Costa Cabral
Abstract
<p><strong>Background:</strong> The Get With The Guidelines – Heart Failure (GWTG-HF) risk score predicts in-hospital mortality of patients admitted with acute HF. However the applicability of this score after discharge has not been studied. The main objective of this paper was to analyze the predictive value for the combined endpoint of mortality and readmission at 6, 12 and 24 months after discharge.</p> <p><strong>Methods</strong>: A retrospective study of patients admitted in the cardiology service with acute HF was performed and GWTG-HF risk score were determined for all patients. All subjects were divided into two groups: higher (=>40 points) and lower (<40 points) score. The patients who were discharge were followed for 2 years and, for each group (higher and lower score), Kaplan-Meier survival curves were determined to ascertain the predictive capacity for our endpoint at 6, 12 and 24 months after discharge.</p> <p><strong>Results</strong>: 1001 patients were included in the study, 50.6% were male and the mean age was 77±10 years old; mean Ejection Fraction (EF) was 49.2±16.3%; mean EF on the group with higher and lower score was, respectively, 48±16,4% and 52±15,6%. The percentage of patients with a EF < 40% on the group with higher and lower score was, respectively, 25% and 31%. There was 69 (6.9%) in-hospital deaths. A ROC curve was determined to ascertain the predictive capacity for in-hospital mortality of the GWTG-HF risk score: c-statistic of 0.705 (p<.001). Then, the 932 patients discharged were followed for two years. At 6, 12 and 24 months the percentage of patients achieving the combinated endpoint was, respectively, 33.2%, 45,4% and 57%. The following Kaplan-Meier survival curves were determined: 6 Months - X<sup>2 </sup>4,309 (p=.038); 12 Months - X<sup>2</sup> 7.767 (p=.005); 24 Months - X<sup>2 </sup>10,770 (p=.001). GWTG score demonstrated to be an independent variable in predicting the 24-month combinated endpoint (HR: 3,067, p = .011) after adjusting for other prognostic variables such as age, DM and chronic kidney disease.</p> <p><strong>Conclusion:</strong> As expected the GWTG-HF risk score is able to predict the in-hospital mortality in patients admitted with acute HF, as it was presented by an acceptable predictive power in this group of patients. In this population, GWTG-HF risk score proved to be an useful multivariable score model for the combined endpoint at 6, 12 and 24 months after discharge. In the future, the aforementioned risk score might be an useful tool in stratifying patients and thereby optimizing treatment and long-term survaillence.</p>
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