"Get with the Guidelines Heart Failure Risk Score" for mortality prediction in patients undergoing MitraClip.

Aged Aged, 80 and over Cardiac Catheterization / methods Cardiac Surgical Procedures / methods Female Germany / epidemiology Guideline Adherence Humans Male Mitral Valve Insufficiency / mortality Retrospective Studies Risk Factors Stroke Volume / physiology Survival Rate / trends Ventricular Function, Left / physiology
Get with the guidelines heart failure risk score Heart failure MitraClip Mortality

Journal

Clinical research in cardiology : official journal of the German Cardiac Society
ISSN: 1861-0692
Titre abrégé: Clin Res Cardiol
Pays: Germany
ID NLM: 101264123

Informations de publication

Date de publication:
Dec 2021
Historique:
received: 31 10 2020
accepted: 09 01 2021
pubmed: 1 2 2021
medline: 17 2 2022
entrez: 31 1 2021
Statut: ppublish

Résumé

Reliable risk scores in patients undergoing transcatheter edge-to-edge mitral valve repair (TMVR) are lacking. Heart failure is common in these patients, and risk scores derived from heart failure populations might help stratify TMVR patients. Consecutive patients from three Heart Centers undergoing TMVR were enrolled to investigate the association of the "Get with the Guidelines Heart Failure Risk Score" (comprising the variables systolic blood pressure, urea nitrogen, blood sodium, age, heart rate, race, history of chronic obstructive lung disease) with all-cause mortality. Among 815 patients with available data 177 patients died during a median follow-up time of 365 days. Estimated 1-year mortality by quartiles of the score (0-37; 38-42, 43-46 and more than 46 points) was 6%, 10%, 23% and 30%, respectively (p < 0.001), with good concordance between observed and predicted mortality rates (goodness of fit test p = 0.46). Every increase of one score point was associated with a 9% increase in the hazard of mortality (95% CI 1.06-1.11%, p < 0.001). The score was associated with long-term mortality independently of left ventricular ejection fraction, NYHA class and NTproBNP, and was equally predictive in primary and secondary mitral regurgitation. The "Get with the Guidelines Heart Failure Risk Score" showed a strong association with mortality in patients undergoing TMVR with additive information beyond traditional risk factors. Given the routinely available variables included in this score, application is easy and broadly possible.

Sections du résumé

BACKGROUND BACKGROUND
Reliable risk scores in patients undergoing transcatheter edge-to-edge mitral valve repair (TMVR) are lacking. Heart failure is common in these patients, and risk scores derived from heart failure populations might help stratify TMVR patients.
METHODS METHODS
Consecutive patients from three Heart Centers undergoing TMVR were enrolled to investigate the association of the "Get with the Guidelines Heart Failure Risk Score" (comprising the variables systolic blood pressure, urea nitrogen, blood sodium, age, heart rate, race, history of chronic obstructive lung disease) with all-cause mortality.
RESULTS RESULTS
Among 815 patients with available data 177 patients died during a median follow-up time of 365 days. Estimated 1-year mortality by quartiles of the score (0-37; 38-42, 43-46 and more than 46 points) was 6%, 10%, 23% and 30%, respectively (p < 0.001), with good concordance between observed and predicted mortality rates (goodness of fit test p = 0.46). Every increase of one score point was associated with a 9% increase in the hazard of mortality (95% CI 1.06-1.11%, p < 0.001). The score was associated with long-term mortality independently of left ventricular ejection fraction, NYHA class and NTproBNP, and was equally predictive in primary and secondary mitral regurgitation.
CONCLUSION CONCLUSIONS
The "Get with the Guidelines Heart Failure Risk Score" showed a strong association with mortality in patients undergoing TMVR with additive information beyond traditional risk factors. Given the routinely available variables included in this score, application is easy and broadly possible.

Identifiants

DOI: 10.1007/s00392-021-01804-3 PMID: 33517496 PMC: PMC8639563
pubmed: 33517496
doi: 10.1007/s00392-021-01804-3
pii: 10.1007/s00392-021-01804-3
pmc: PMC8639563
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1871-1880

Informations de copyright

© 2021. The Author(s).

Références

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Auteurs

Christos Iliadis (C)

Department of Cardiology, Angiology, Pneumology and Medical Intensive Care, Heart Center of the University of Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany. christos.iliadis@uk-koeln.de.
ORCID: 0000-0001-7655-8500

Maximilian Spieker (M)

Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine University Düsseldorf, Medical Faculty, Düsseldorf, Germany.

Refik Kavsur (R)

Department of Cardiology, Angiology, Pneumology and Medical Intensive Care, University Hospital Bonn, Bonn, Germany.

Clemens Metze (C)

Department of Cardiology, Angiology, Pneumology and Medical Intensive Care, Heart Center of the University of Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.

Martin Hellmich (M)

Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.

Patrick Horn (P)

Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine University Düsseldorf, Medical Faculty, Düsseldorf, Germany.

Ralf Westenfeld (R)

Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine University Düsseldorf, Medical Faculty, Düsseldorf, Germany.

Vedat Tiyerili (V)

Department of Cardiology, Angiology, Pneumology and Medical Intensive Care, University Hospital Bonn, Bonn, Germany.

Marc Ulrich Becher (MU)

Department of Cardiology, Angiology, Pneumology and Medical Intensive Care, University Hospital Bonn, Bonn, Germany.

Malte Kelm (M)

Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine University Düsseldorf, Medical Faculty, Düsseldorf, Germany.

Georg Nickenig (G)

Department of Cardiology, Angiology, Pneumology and Medical Intensive Care, University Hospital Bonn, Bonn, Germany.

Stephan Baldus (S)

Department of Cardiology, Angiology, Pneumology and Medical Intensive Care, Heart Center of the University of Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.

Roman Pfister (R)

Department of Cardiology, Angiology, Pneumology and Medical Intensive Care, Heart Center of the University of Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › "Get with the Guidelines Heart Failure Risk...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Sujet âgé de 80 ans ou plus › "Get with the Guidelines Heart Failure Risk...
questionsmedicales.fr › Techniques d'investigation › Cathétérisme › Cathétérisme cardiaque › "Get with the Guidelines Heart Failure Risk...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie thoracique › Procédures de chirurgie cardiaque › "Get with the Guidelines Heart Failure Risk...
questionsmedicales.fr › Régions géographiques › Europe › Allemagne › "Get with the Guidelines Heart Failure Risk...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Adhésion aux directives › "Get with the Guidelines Heart Failure Risk...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › "Get with the Guidelines Heart Failure Risk...
questionsmedicales.fr › Maladies cardiovasculaires › Cardiopathies › Valvulopathies › Insuffisance mitrale › "Get with the Guidelines Heart Failure Risk...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › "Get with the Guidelines Heart Failure Risk...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › "Get with the Guidelines Heart Failure Risk...
questionsmedicales.fr › Phénomènes physiologiques respiratoires et circulatoires › Phénomènes physiologiques cardiovasculaires › Hémodynamique › Débit cardiaque › Débit systolique › "Get with the Guidelines Heart Failure Risk...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Registre civil › Mortalité › Taux de survie › "Get with the Guidelines Heart Failure Risk...
questionsmedicales.fr › Phénomènes physiologiques respiratoires et circulatoires › Phénomènes physiologiques cardiovasculaires › Fonction ventriculaire › Fonction ventriculaire gauche › "Get with the Guidelines Heart Failure Risk...