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Essen Stroke Risk Score Predicts Clinical Outcomes in Heart Failure Patients with Preserved Ejection Fraction:
Wengen Zhu1,2,3, Yalin Cao4, Min Ye1,2
1Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.
Thrombosis and Haemostasis
|August 29, 2022
Summary
The Essen Stroke Risk Score (ESRS) effectively predicts stroke and other adverse events in heart failure with preserved ejection fraction (HFpEF) patients. This score shows better calibration than other common risk scores for HFpEF.
Area of Science:
- Cardiology
- Clinical Risk Stratification
- Public Health
Background:
- Heart failure with preserved ejection fraction (HFpEF) presents significant risks for stroke and other adverse clinical outcomes.
- Identifying reliable risk stratification tools is crucial for managing HFpEF patients.
Purpose of the Study:
- To evaluate the predictive capability of the Essen Stroke Risk Score (ESRS) for clinical outcomes in HFpEF patients.
- To compare the performance of ESRS against established stroke risk scores (R2CHADS2, CHADS2, CHA2DS2-VASC) in this population.
Main Methods:
- Utilized data from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial, including 3,441 HFpEF patients.
- Employed Cox proportional hazard models with competing risk regression to assess ESRS associations with outcomes.
- Evaluated diagnostic accuracy using C-index and calibration curves.
Main Results:
- Higher ESRS was significantly associated with increased risks of stroke, myocardial infarction, HF hospitalization, all-cause death, and cardiovascular death.
- The risk of stroke increased from 0.32% per year (ESRS 1-2) to 1.71% per year (ESRS ≥6).
- ESRS demonstrated better calibration for predicting stroke risk in HFpEF compared to R2CHADS2, CHADS2, and CHA2DS2-VASC scores.
Conclusions:
- The ESRS possesses modest discriminatory ability for predicting stroke and other adverse outcomes in HFpEF.
- ESRS may offer superior calibration performance over other stroke risk scores for HFpEF patients at high risk.
- The ESRS can aid in risk stratification and management of HFpEF patients.
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