Differential clinical prognostic classifications in dilated and ischemic advanced heart failure: the EPICAL study

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F Alla1, S Briançon, Y Juillière

  • 1Department of Epidemiology and Cardiology, University Hospital, Nancy, France. f.alla@chu-nancy.fr

American Heart Journal
|April 27, 2000
PubMed

Insights

A new prognostic rating system for severe congestive heart failure (CHF) was developed. This tool aids physicians in patient management and clinical trial stratification by predicting 1-year survival rates.

Area of Science:

  • Cardiology
  • Clinical Prognostics

Background:

  • Clinical management of severe congestive heart failure (CHF) requires prognosis-based grading.
  • An objective was to develop a prognostic rating system for severe CHF.

Purpose of the Study:

  • To elaborate a prognostic rating system for severe congestive heart failure (CHF).

Main Methods:

  • The EPICAL program identified severe CHF patients (NYHA class III/IV, low ejection fraction, or high cardiothoracic index).
  • Baseline variables were analyzed using Cox multivariate models.

Main Results:

  • Ischemic heart disease patients had lower 1-year survival (57.6%) than dilated cardiomyopathy patients (69.1%).
  • Multivariate analysis identified 5 prognostic factors for ischemic CHF and 7 for dilated cardiomyopathy CHF.
  • Patients were classified into good (>75%), intermediate, or poor (

Conclusions:

  • A prognostic prediction score was derived from readily available data.
  • This score assists physicians in decision-making and serves as a stratification tool for clinical trials.
Abstract

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