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GRACE score in acute heart failure patients: an additional value?
Session:
Painel 2 - Insuficiencia Cardiaca 6
Speaker:
Hélder Santos
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:
Helder Santos; Inês Grácio De Almeida; Mariana Da Silva Santos; Hugo Miranda; Catarina Sá; Samuel Almeida; Joana Chan Chin; Catarina Santos De Sousa; Luís Santos; Lurdes Almeida; João Tavares
Abstract
<p><strong>Introduction:</strong> GRACE score is a validated and established tool used to stratify and predict mortality risk in non-ST-elevation myocardial infarction patients. However, GRACE score capability to predict mortality in heart failure patients has not been validated.</p> <p><strong>Objective:</strong> Validation of the GRACE score as a predictive tool of mortality in patients admitted with <em>de novo</em> acute heart failure in a peripheral centre.</p> <p><strong>Methods</strong>: Single-centre retrospective study, engaging patients hospitalized for <em>de novo</em> acute heart failure with reduced ejection fraction between 1/01/2010-31/12/2017. All patients’ clinical data were extracted at admission and the follow up occurred in our centre. GRACE score was assessed at admission. Patients were divided in four groups, according to GRACE points: group A ≤90 points, B 91-130 points, C 131-170 points and D ≥171 points. Chi-square and ANOVA tests were used to compare categorical and continuous variables. Logistic regression was performed to assess the relationship between the GRACE score and mortality. To evaluate the survival rates between groups Kaplan-Meier method was used (log-rank test).</p> <p><strong>Results</strong>: 300 patients were included, 72.7% were male, mean age 67.42 ± 12.57 years with 41.68 ± 34.18 months of follow up, left ventricular ejection fraction (LVEF) of 33.72 ± 12.19 and a mean GRACE score 146.60 ± 29.76. The four groups were similar regarding gender, cardiovascular risk factors, rhythm at admission and LVEF. As expected, the categorization of patients in 4 groups, revealed significant differences between the groups, namely in mean age (37.56 ± 8.56, 59.43 ± 11.29, 69.18 ± 8.52, 78.68 ± 7.54, <em>p</em><0.001), GRACE score and survival rates. Logistic regression revealed that GRACE score was associated with mortality (odds ratio (OR) 2.34, <em>p</em><0.001, confidence interval (CI) 1.67-2.37), nevertheless it was not associated to readmission for all causes (<em>p</em>=0.161). Mortality rates significantly increase with the GRACE score (11.1, 46.0, 66.2, 79.47%), with a Kaplan-Meier test of <em>p</em><0.001 – figure 1.</p> <p><strong>Conclusions:</strong> GRACE score, largely implemented in acute coronary syndromes, proved to be a relevant predictor of mortality in <em>de novo</em> heart failure patients with reduced ejection fraction.</p>
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