scholarly journals MODEL OF END-STAGE LIVER DISEASE EXCLUDING INR (MELD-XI) SCORING SYSTEM PROVIDES THE ADDITIONAL LONG-TERM PROGNOSTIC INFORMATION TO ADHERE RISK LEVEL IN PATIENTS ADMITTED WITH ACUTE DECOMPENSATED HEART FAILURE

2016 ◽  
Vol 67 (13) ◽  
pp. 1418
Author(s):  
Takahisa Yamada ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
Shunsuke Tamaki ◽  
Yusuke Iwasaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Disease ◽  
Scoring System ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Risk Level ◽  
Prognostic Information ◽  
End Stage Liver Disease ◽  
End Stage

Abstract 12660: Model of End-Stage Liver Disease Excluding INR (MELD-XI) Scoring System Provides the Long-Term Prognostic Information in Patients Admitted With Acute Decompensated Heart Failure, Regardless of Reduced or Preserve Left Ventricular Ejection Fraction

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Takahisa Yamada ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
Shunsuke Tamaki ◽  
Yusuke Iwasaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Scoring System ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Prognostic Information ◽  
Ventricular Ejection Fraction ◽  
Cox Analysis

Backgrounds: Liver dysfunction has a prognostic impact on the outcome of patients with advanced heart failure. A model of end-stage liver disease excluding INR (MELD-XI) is a robust scoring system of liver dysfunction, and a high score has been shown to be associated with poor prognosis in patients with heart failure. However, there is little information available on the long-term prognostic significance of MELD-XI score in patients admitted with acute decompensated heart failure (ADHF), relating to reduced or preserved left ventricular ejection fraction (HFrEF or HFpEF). Methods and Results: We studied 303 consecutive patients admitted with ADHF and discharged with survival (HFrEF(LVEF<50%); n=163, HFpEF;n=140). MELD-XI score was calculated by the following formula: 5.11[[Unable to Display Character: &#65381;]]ln(bilirubin)+11.79[[Unable to Display Character: &#65381;]]ln(creatinine)+9.44. During a follow-up period of 5.0±4.3 yrs, 75 patients had cardiovascular death (CVD). Receiver-operator curve analysis revealed that MELD-XI score of 12 was a fair discriminator for CVD (AUC 0.704 (95%CI 0.635-0.772), p<0.0001; sensitivity 67% and specificity 62%). In HFrEF group, MELD-XI score was significantly independently associated with CVD (p=0.0037) at multivariate Cox analysis, and patients with high MELD-XI score (≥12) had a higher risk of CVD than those with low MELD score (46% vs 24%, p=0.0038, hazard ratio: 2.20 (95%CI 1.27-3.79)). In HFpEF group, MELD-XI score was also significantly independently associated with CVD (p=0.005) at multivariate Cox analysis, and patients with high MELD-XI score (≥12) had a higher risk of CVD (34% vs 8%, p<0.0001, hazard ratio: 6.25 (95%CI 2.59-15.05)). Conclusion: A MELD-XI scoring system would provide the long-term prognostic information in patients admitted with ADHF, regardless of HFrEF or HFpEF.

Abstract 12912: Model of End-Stage Liver Disease Excluding INR (MELD-XI) Scoring System Predicts Mode of Death in Patients Admitted With Acute Decompensated Heart Failure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Takahisa Yamada ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
Shunsuke Tamaki ◽  
Yusuke Iwasaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Scoring System ◽  
Cardiac Death ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Pump Failure ◽  
End Stage Liver Disease ◽  
Patients With Heart Failure ◽  
End Stage ◽  
Mode Of Death

Backgrounds: Cardiohepatic interactions have been a focus of attention among heart failure. A model of end-stage liver disease excluding INR (MELD-XI) is a robust scoring system of liver dysfunction, and a high score has been shown to be associated with poor prognosis in patients with heart failure. Prediction of mode of death (sudden cardiac death (SCD) and pump failure death (PFD)) in patients with heart failure may facilitate decisions about specific medications or devices. However, there is no information available on the prognostic significance of MELD-XI in patients admitted with acute decompensated heart failure (ADHF), from the viewpoint of mode of death. Methods and Results: We studied 303 consecutive patients admitted with ADHF and discharged with survival. MELD-XI score was calculated by the following formula: 5.11[[Unable to Display Character: &#65381;]]ln(bilirubin)+11.79[[Unable to Display Character: &#65381;]]ln(creatinine)+9.44. During a follow-up period of 5.0±4.3 yrs, 37 patients had SCD and 27 patients had PFD. At multivariate Cox analysis, MELD-XI score was significantly independently associated with SCD (p=0.002) and PFD (p=0.003). Receiver-operator curve analysis revealed that MELD-XI of 11 and 13 was fair discriminators for SCD (AUC 0.667(95%CI 0.575-0.758), p=0.001; sensitivity 78% and specificity 48%) and PFD (AUC 0.764(95%CI 0.683-0.845; sensitivity 74% and specificity 69%), p<0.0001), respectively. Patients with higher MELD-XI score had significantly a higher risk of not only SCD (17% vs 6%, p=0.0005, adjusted HR: 3.19 (95%CI 1.44-7.08) but also PFD (20% vs 3%, p<0.0001, adjusted HR: 4.53 (95%CI 1.72-12.07)), compared to those with lower MELD-XI score. Conclusion: A MELD-XI scoring system might predict not only sudden cardiac death but also pump failure death in patients admitted with ADHF.

scholarly journals Liver Dysfunction Assessed by Model for End-Stage Liver Disease Excluding INR (MELD-XI) Scoring System Predicts Adverse Prognosis in Heart Failure

PLoS ONE ◽  
2014 ◽  
Vol 9 (6) ◽  
pp. e100618 ◽  
Author(s):  
Satoshi Abe ◽  
Akiomi Yoshihisa ◽  
Mai Takiguchi ◽  
Takeshi Shimizu ◽  
Yuichi Nakamura ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Disease ◽  
Liver Dysfunction ◽  
Scoring System ◽  
End Stage Liver Disease ◽  
End Stage
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