The MUSIC Risk score: a simple method for predicting mortality in ambulatory patients with chronic heart failure
Por:
Vazquez, R, Bayes-Genis, A, Cygankiewicz, I, Pascual-Figal, D, Grigorian-Shamagian, L, Pavon, R, Gonzalez-Juanatey, JR, Cubero, JM, Pastor, L, Ordonez-Llanos, J, Cinca, J, de Luna, AB
Publicada:
1 may 2009
Resumen:
The prognosis of chronic heart failure (CHF) is extremely variable, although generally poor. The purpose of this study was to develop prognostic models for CHF patients.
A cohort of 992 consecutive ambulatory CHF patients was prospectively followed for a median of 44 months. Multivariable Cox models were developed to predict all-cause mortality (n = 267), cardiac mortality (primary end-point, n = 213), pump-failure death (n = 123), and sudden death (n = 90). The four final models included several combinations of the same 10 independent predictors: prior atherosclerotic vascular event, left atrial size > 26 mm/m(2), ejection fraction <= 35%, atrial fibrillation, left bundle-branch block or intraventricular conduction delay, non-sustained ventricular tachycardia and frequent ventricular premature beats, estimated glomerular filtration rate < 60 mL/min/1.73 m(2), hyponatremia <= 138 mEq/L, NT-proBNP > 1.000 ng/L, and troponin-positive. On the basis of Cox models, the MUSIC Risk scores were calculated. A cardiac mortality score > 20 points identified a high-risk subgroup with a four-fold cardiac mortality risk.
A simple score with a limited number of non-invasive variables successfully predicted cardiac mortality in a real-life cohort of CHF patients. The use of this model in clinical practice identifies a subgroup of high-risk patients that should be closely managed.
Filiaciones:
Vazquez, R:
Valme Univ Hosp, Serv Cardiol, Seville 41014, Spain
Bayes-Genis, A:
Univ Hosp St Pau, Serv Cardiol, Barcelona, Spain
Cygankiewicz, I:
Univ Hosp St Pau, Serv Cardiol, Barcelona, Spain
Pascual-Figal, D:
Univ Hosp Arrixaca, Serv Cardiol, Murcia, Spain
Grigorian-Shamagian, L:
Univ Hosp Santiago Compostela, Serv Cardiol, Galicia, Spain
Pavon, R:
Valme Univ Hosp, Serv Cardiol, Seville 41014, Spain
Gonzalez-Juanatey, JR:
Univ Hosp Santiago Compostela, Serv Cardiol, Galicia, Spain
Cubero, JM:
Valme Univ Hosp, Serv Cardiol, Seville 41014, Spain
Pastor, L:
Valme Univ Hosp, Serv Cardiol, Seville 41014, Spain
Ordonez-Llanos, J:
Hosp Santa Creu & Sant Pau, Serv Biochem, Barcelona, Spain
Cinca, J:
Univ Hosp St Pau, Serv Cardiol, Barcelona, Spain
de Luna, AB:
Univ Hosp St Pau, Serv Cardiol, Barcelona, Spain
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