晚期心力衰竭患者的心力衰竭风险评分:来自LEVO-D注册表的见解
Pau Codina1,2, David Dobarro3, Javier de Juan-Bagudá4,5,6
1Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
ESC heart failure
|November 22, 2023
概括
现有的心力衰竭风险评分显示,接受levosimendan治疗的患者的准确性不佳. 对于晚期心力衰竭 (HF) 需要新的,专门的得分来改善死亡率预测.
科学领域:
- 心脏病学 心脏病学
- 医疗信息学 医疗信息学
- 临床研究 临床研究
背景情况:
- 由于患者生存率的改善,先进心力衰竭 (HF) 的患病率正在上升.
- 准确的死亡率预测对于管理高级HF患者至关重要.
- 在这个人群中,基于网络的HF风险评分的表现数据有限.
研究的目的:
- 为了评估MAGGIC-HF风险评分的死亡率预测准确度.
- 评估 BCN-Bio-HF风险计算器的性能,包括N-终端脑前性尿素,在晚期HF患者中.
- 为了比较接受levosimendan作为目的地治疗的患者的这些得分.
主要方法:
- 分析了接受间歇性levosimendan治疗的403名晚期HF患者的队列.
- 使用歧视 (AUC,Harrell的C统计) 和1年校准来评估死亡率预测.
- 患者的特征包括人口统计,减少喷射率和缺血性心脏病的患病率.
主要成果:
- 观察到的一年死亡率为26.8%.
- 根据BCN-Bio-HF预测的1年死亡率为17.0%,根据MAGGIC-HF预测的1年死亡率为22.1%.
- 这两种评分都显示了低于最佳的歧视 (BCN-Bio-HF AUC 0.66,MAGGIC-HF AUC 0.62) 和校准,低估了风险.
结论:
- MAGGIC-HF和 BCN-Bio-HF风险评分在接受levosimendan.com治疗的晚期HF患者中表现不充分.
- 这些得分低估了这一特定患者群体的死亡风险.
- 开发针对高级HF的量身定制的风险预测工具是必要的.
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