Clinical value of a comprehensive clinical- and echocardiography-based risk score on predicting cardiovascular...

Area of Science:

• Cardiology
• Clinical Risk Prediction
• Heart Failure Research

Background:

• Ischemic heart failure (IHF) with reduced left ventricular ejection fraction (LVEF) poses significant cardiovascular (CV) risks.
• Accurate prediction of adverse CV outcomes is crucial for managing IHF patients.
• Existing risk stratification tools may not fully capture the complexity of IHF prognosis.

Purpose of the Study:

• To develop and validate a comprehensive risk score combining clinical and echocardiographic data for predicting CV adverse outcomes in IHF patients with LVEF < 50%.
• To establish a reliable tool for risk stratification and clinical decision-making in this patient population.

Main Methods:

• Retrospective cohort study of 1341 hospitalized IHF patients (LVEF < 50%) from 2009-2017.
• Development of a prediction model (C&E risk score) using Cox regression and nomogram for CV mortality and CV events.
• Internal and external validation of the C&E risk score's predictive performance.

Main Results:

• The C&E risk score demonstrated superior predictive performance for CV outcomes compared to clinical- or echocardiography-only models.
• The risk score showed significant predictive ability for CV mortality (AUC 0.740) and CV events (AUC 0.678) upon internal validation.
• Patients categorized by the C&E risk score exhibited distinct rates of CV mortality and events, confirming its prognostic efficacy.

Conclusions:

• The novel C&E risk score is a validated and reliable tool for predicting CV outcomes in IHF patients with reduced LVEF.
• The risk score facilitates enhanced risk stratification, potentially improving clinical decision-making for high-risk individuals.