SPC365

Predicting Heart Failure Outcomes with a new Malnutrition and Inflammation Severity Index - MISI Score

Session: Sessão de Posters 18 - Insuficiência cardíaca - Fatores preditores
Speaker: Francisco Rodrigues Dos Santos

Congress: CPC 2024
Topic: D. Heart Failure
Theme: 10. Chronic Heart Failure
Subtheme: 10.6 Chronic Heart Failure - Clinical
Session Type: Cartazes
FP Number: ---
Authors: Francisco Rodrigues Dos Santos; Vanda Devesa Neto; António Costa; Inês Pires; Joana Correia; João Gouveia Fiuza; Oliver Correia Kungel
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><em><strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Background:</span></strong></em><span style="font-family:&quot;Calibri Light&quot;,sans-serif"> Malnutrition and inflammation frequently coexist in chronic heart failure, with significant impact in morbidity and mortality. Despite their prevalence, these factors often go unnoticed in clinical assessments. The need for an accessible and accurate predictive tool prompted the development of a new score - Malnutrition and Inflammation Severity Index (MISI score). This study aims to assess the predictive capability of the MISI score for 24-month (24MM) mortality in patients with chronic heart failure and compare its effectiveness against a previously validated score &ndash; Get With The Guidelines (GWTG) score. &nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><em><strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Methods:</span></strong></em><em><span style="font-family:&quot;Calibri Light&quot;,sans-serif"> R</span></em><span style="font-family:&quot;Calibri Light&quot;,sans-serif">etrospective analysis involving <span style="background-color:white"><span style="color:#333333">1052 patients</span></span> admitted in the cardiology department due to chronic heart failure. The MISI score, a novel index combining objective measures of malnutrition and inflammation, was calculated for each participant</span><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#333333"> attributing points for each variable, according to the odds ratio on univariate analysis. MISI score (0-7) consists of body mass index values (2 points), albumin values (2 points), Ferritin levels (1 point), C-Reactive Protein levels (1 point) and age (1 point). </span></span><span style="background-color:white"><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#333333">Patients were considered high risk if they had a MISI &ge;5. Kaplan-Meyer and Cox-regression analyses were performed to evaluate MISI score association with 24 months-mortality (24MM). ROC curve analysis was used to compare the predictive value compared to the previously validated GWTG score. &nbsp;</span></span></span></span></span></p>

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

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="background-color:white"><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#333333">Mean patient age was 77 (&plusmn;10) years; 51% were men. Mean left ventricle ejection fraction (EF)&nbsp;was 49% (&plusmn;16.4). EF&lt;40% was present in 31% of patients. In-hospital mortality and 24-MM were&nbsp;6.5% and 17.1%, respectively. Kaplan-Meyer curve analysis revealed a significantly lower median time to 24MM in high-risk patients compared to low-risk patients (395 days vs. 665 days, </span></span></span><span style="background-color:white"><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#333333">&chi;</span></span></span><span style="background-color:white"><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#333333">2=62.7, p&lt;0.01). ROC curve analysis revealed that the MISI score had a better predictive performance for 24MM in comparison to GWTG score (AUC 0.81 vs 0.66; p&lt;0.01). Cox regression analysis demonstrated that MISI score 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></span></p>

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

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">The MISI score emerges as a promising and accessible tool for predicting 24MM mortality in patients with chronic heart failure. Its ability to capture the synergistic effects of malnutrition and inflammation highlights its potential clinical utility. Early identification and intervention based on the MISI score may lead to improved outcomes in this high-risk population. Further validation studies and prospective trials are warranted to establish the MISI score&#39;s robustness and reliability in diverse clinical settings.</span></span></span></p>

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