SPC365

A new predictive score to evaluate the impact of malnutrition and inflammation in patients with heart failure – MAI-HF score

Session: Posters (Sessão 4 - Écran 2) - Insuficiência cardíaca - estratificação de risco
Speaker: Vanda Neto

Congress: CPC 2023
Topic: D. Heart Failure
Theme: 10. Chronic Heart Failure
Subtheme: 10.2 Chronic Heart Failure – Epidemiology, Prognosis, Outcome
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Vanda Devesa Neto; Joana Correia; João Fiuza; Gonçalo Ferreira; Luis Ferreira Santos; Bruno Marmelo; Inês Pires; Davide Moreira; José Costa Cabral

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Introduction: </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Malnutrition and inflammation in chronic heart failure, although frequent and with substantially impacting mortality, are often overlooked. Therefore, we aimed to evaluate if a new objective and simple index &ndash; Malnutrition And Inflammation in Heart Failure (MAI-HF) score - can predict outcomes in this population.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Purpose: </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#0e101a">Identify the association between MAI-HF score on 12-month (12MM) and 24-month (24MM) mortality in patients with chronic heart failure.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Methods: </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">A retrospective analysis of 981 patients admitted to a Cardiology ward due to HF was performed. The variables - modified body mass index (albumin x body mass index), C-reactive protein levels, cholesterol levels, ferritin levels, and age - were selected for frailty and inflammation assessment. After attributing points for each variable, according to the odds ratio on univariate analysis, the MAI-HF was calculated (range 0-6), resulting from the sum of the points attributed to each variable. Kaplan-Meyer and Cox-regression analyses were performed to evaluate MAI-HF association with 12MM and 24MM. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Results: </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">49% of patients were men; mean age was 77 (&plusmn;11) years. Mean LVEF was 49% (&plusmn;16). LVEF&lt;40% was present in 29% of patients. 50% had atrial fibrillation, 14% had a history of acute myocardial infarction, and 64% had hypertension. 12MM and 24MM were, respectively, 13% and 15%. Patients were considered high risk if they had an MAI-HF &ge;5. Kaplan-Meyer curve analysis revealed a significantly lower median time to 12MM in high-risk patients, as assessed by MAI-HF, compared to low-risk patients (256 days vs. 356 days, mortality rate: 29% vs. 3%, &chi;2=17.731, p&lt;0.001). There was also a significantly lower median time to 24MM in high-risk patients (502 days vs. 706 days, mortality rate: 26% vs. 3%, &chi;2=9.270, p=0.002). ROC curve analysis revealed that the MAI-HF score had a good predictive performance for 12MM (AUC 0.748; CI 0.629 - 0.866; p=0.01) and 24MM (AUC 0.741; CI 0.616 &ndash; 0.867; p=0.02). Cox regression analysis demonstrated that MAI-HF independently predicts 24MM even after adjustment for other prognostic markers, such as the presence of atrial fibrillation, history of myocardial infarction, and diabetes. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Conclusion:</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">MAI-HF is a simple and objective index to evaluate the impact of malnutrition and inflammation in patients with chronic heart failure. Its use may help identify patients with high mortality risk and needing specialized care.</span></span></span></span></p>