scholarly journals Comparison of one-year survival prediction tools in patients with advanced heart failure

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M Blum ◽  
K McKendrick ◽  
L.P Gelfman ◽  
N.E Goldstein
Keyword(s):  
Heart Failure ◽  
Roc Curve ◽  
Performance Metrics ◽  
Prediction Models ◽  
Advanced Heart Failure ◽  
Survival Prediction ◽  
Survival Status ◽  
Risk Of Death ◽  
Prognostic Utility ◽  
One Year

Abstract Background Predicting survival in patients with advanced heart failure (HF) remains difficult and prognostic scores such as the Seattle Heart Failure Model (SHFM) are cumbersome to use. Alternative approaches like the Surprise Question (SC) or the number of HF hospitalisations within the last year (NoH) could simplify prognostication. Purpose We assessed the prognostic utility of the SHFM, SC and NoH for predicting one-year survival status in patients with advanced HF. Methods A secondary analysis of a multisite, single-blinded cluster-randomized, controlled trial to test whether a structured intervention of educational content and automated reminders increased the likelihood of ICD deactivation conversations and ICD deactivation. The study was performed within the advanced HF practices at six US academic medical centers, between September 2011 to February 2016. Patient eligibility criteria included advanced HF, an implantable cardiac defibrillator and a high risk of death, with complete data on SHFM, SC, NoH and one-year survival status. SHFM survival was calculated from baseline variables; the SC (“Would you be surprised if the patient were to die within one year?”) was answered by cardiologists; and the NoH was extracted from medical records. For prediction of survival status, cut-offs for predicted survival per SHFM and NoH were chosen empirically by means of receiver operating characteristic (ROC) curve analysis maximising Youden's index. The resulting binary prediction models were assessed based on area under the ROC curve (AUC), sensitivity and specificity. Results Of the 535 subjects in our sample, 82 (15.3%) had died after one-year of follow-up. For the SHFM and the NoH, optimal cut-offs were found to be a predicted survival <86% and ≥2 hospitalisations, respectively. Performance metrics of prognostic models are detailed in Table 1. The SHFM yielded an AUC of 0.65 (0.60–0.71 95% confidence interval [CI]), a sensitivity of 0.76 (0.65–0.84 95% CI), and a specificity of 0.55 (0.50–0.60 95% CI). The SC demonstrated a comparable AUC 0.58 (0.54–0.63 95% CI), similar sensitivity 0.84 (0.74–0.91 95% CI), but lower specificity 0.33 (0.28–0.37 95% CI) compared to the SHFM. The NoH demonstrated a comparable AUC 0.56 (0.50–0.62 95% CI), similar sensitivity 0.56 (0.45–0.67 95% CI), and similar specificity 0.56 (0.51–0.61 95% CI) compared to the SHFM. The combination of positive SC and NoH ≥2 showed significantly higher specificity compared to the SHFM (0.68 [0.64–0.73 95% CI]). Conclusion The SC and NoH are clinically feasible bedside alternatives to the more complex SHFM model, yet yield similar overall prognostic utility for one-year survival status among advanced HF patients. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Heart, Lung, and Blood Institute

Abstract 5853: Continuous Flow Left Ventricular Assist Device in Women with Advanced Heart Failure: Results After One Year of Support

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Salpy V Pamboukian ◽  
Roberta C Bogaev ◽  
Stuart D Russell ◽  
Andrew J Boyle ◽  
Nader Moazami ◽  
...  
Keyword(s):  
Heart Failure ◽  
Continuous Flow ◽  
Cardiac Transplantation ◽  
Causes Of Death ◽  
Left Ventricular ◽  
Advanced Heart Failure ◽  
Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
One Year

Small continuous flow left ventricular assist devices (LVAD) are providing new options for women in advanced heart failure who due to body size limitations were historically excluded from use of large first generation pulsatile devices. We report the experience of women one year after implantation with the new, HeartMate II continuous flow LVAD for bridge to transplantation. Patients (n=279), 24% female (F), 76% male (M) in NYHA Class IV heart failure, LV ejection fraction 16±7% (F), 16±6% (M), mostly inotrope dependent and about half on intraaortic balloon pump support (50% F, 43% M), who had been enrolled in the HM II clinical trial for at least 1 year as a bridge to cardiac transplantation at 33 centers were analyzed. Outcomes and causes of death in the first year of support between F and M recipients were determined. The percentage of patients who had undergone transplantation, recovery of the heart with device removal, or continued on HM II support after one year were the same (80%) between M and F. However, the percentage of patients who had received a heart transplant was significantly less for F (38%) than M (53%) (p<0.05). Median duration of support for F was 226 days (range 8–1004) vs. 143 days (range 0–1057) for M. Mortality on device support was 20% for F and 18% M. There were no statistically significant differences in leading causes of death: sepsis (1.5% F vs 4.2% M), ischemic stroke (3.1% F vs 1.9% M), hemorrhagic stroke (3.1% F vs 1.4% M), and right heart failure (3.1% F vs 1.9% M). Of 82 patients continuing on support at 1 year, 26 (32%) were F with median BSA of 1.65 vs 2.14 m 2 for M. Kaplan Meier survival at one year was similar for females (74%) and males (76%). The smaller, more durable HM II rotary LVAD may be especially advantageous to women with advanced HF as a bridge to cardiac transplantation, because of significantly smaller BSA and need for extended duration of mechanical support due to longer wait times for suitable organ donors. Outcomes at one-year

Biomarkers associated with poor prognosis in patients with end-stage heart failure

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
W Szczurek ◽  
M Gasior ◽  
M Skrzypek ◽  
E Romuk ◽  
B Szygula Jurkiewicz
Keyword(s):  
Heart Failure ◽  
Poor Prognosis ◽  
Funding Source ◽  
Elisa Kit ◽  
Risk Of Death ◽  
End Stage Heart Failure ◽  
One Year ◽  
End Stage ◽  
Medical University

Abstract Background Despite advances in the treatment, end-stage heart failure (HF) is a disease with a severe prognosis, showing an annual mortality rate of 30 to 50%. Due to a poor prognosis in this population of patients, it is necessary to accurately stratify the risk of death, including simple and effective prognostic markers. Objective This study aimed to determine biomarkers associated with mortality in patients with end-stage HF. Material and methods The study was a prospective analysis of optimally treated patients with end-stage HF, who were hospitalised at the Cardiology Department between 2016 and 2018. At the time of enrollment to the study routine laboratory tests, cardiopulmonary exercise tests, echocardiography and right heart catheterization were performed in all patients. Human Interleukin 33 (IL-33) and IL-1 Receptor Like 1 (IL1RL1) were measured by sandwich enzyme-linked immunosorbent assay (ELISA) with the commercially available kit (Human Il-33 and IL1RL1 ELISA kit, SunRedBio Technology Co, Ltd, Shanghai, China). Plasma concentration of N-terminal brain natriuretic peptide (NT-proBNP) was measured using a commercially available kit (Human NTproBNP ELISA kit, Roche Diagnostics, Mannheim, Germany). The endpoint was all-cause mortality during a one-year follow-up. The Medical University of Silesia's local Institutional Review Board approved the study protocol, and all patients provided informed consent. Results The final study group consisted of 282 patients (87.6% males, median age 57.0 years). One-year mortality rate in the analysed population was 28%. In a multivariate analysis, independent risk factors of death included NT-proBNP [Hazard Ratio (HR) 1.056 (95% Confidence Interval (CI): 1.024–1.089); P&lt;0.001], sodium [HR 0.877 (95% CI: 0.815–0.944); p&lt;0.001], IL33 [HR 0.977 (95% CI: 0.965- 0.989); p&lt;0.001] and IL1RL1 [HR 1.015 (95% CI: 1.008–1.023); p&lt;0.001) serum levels. Conclusions Our study showed that lower sodium and IL-33 levels, as well as higher NT-proBNP and IL1RL1 levels are associated with an increased risk of death in patients with end-stage HF during a one-year follow-up. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Medical University of SIlesia, Katowice, Poland

scholarly journals Predictors of one-year mortality in ambulatory patients with advanced heart failure awaiting heart transplantation

2021 ◽  
Author(s):  
Wioletta Szczurek-Wasilewicz ◽  
Mariusz Gąsior ◽  
Michał Skrzypek ◽  
Kamila Kurkiewicz ◽  
Bożena Szyguła-Jurkiewicz
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Advanced Heart Failure ◽  
Ambulatory Patients ◽  
One Year

scholarly journals Heart failure in low risk patients with atrial fibrillation, nationwide registry case-control study based on 227811 patients

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C Basic ◽  
P Hansson ◽  
T Zverkova-Sandstrom ◽  
B Johansson ◽  
M Fu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Incidence Rate ◽  
Prediction Models ◽  
Risk Profile ◽  
Cardiovascular Risk Profile ◽  
One Year ◽  
Low Cardiovascular Risk

Abstract Background Heart failure (HF) is common in patients with atrial fibrillation (AF), and also associated with worse outcome. Consequently, it is commonly included in risk prediction models for AF, used in daily clinical praxis. However, knowledge about the association between solely AF and incidental HF is limited. Aim This study aims to evaluate the short and long-term risks for onset of HF in patients with AF and low cardiovascular risk profile. Methods All patients with first recorded hospitalization for AF in the Swedish National Patient Register, were included from the 1St January 1987 to 31st December 2018. Each patient with AF was matched by age, sex and county with two controls from the Swedish Total Population Register. Patients &lt;18 years, or with concomitant hypertension, diabetes mellitus, coronary and periphery artery disease, previous stroke or transitory ischemic attack, cardiomyopathy, pulmonary arterial hypertension, congenital heart disease, valvular heart disease and renal failure prior or at baseline were excluded. Results In total 227 811 patients and 452 712 controls met the inclusion and exclusion criteria and were included in the study. The incidence rate for incidental HF per 1000 person-year within one year after AF diagnosis was 6.2 (95% CI: 4.5–8.6) among patient 18–34, increased with increasing age and was 142.8 (95% CI: 139.4–146.3) among those &gt;80 years. Within five years the incidence rate decreased in all age categories and was 2.4 (95% CI: 1.8–3.0) among the youngest and 94.0 (95% CI: 92.4–95.6) in the oldest age group. When compared to matched controls from the general population patients with AF had a hazard ratio (HR) and CI 95% to develop HF within one year at 103.9 (46.3–233.1), 34.9 (26.5–45.9), 17.5 (15.5–19.8), 10.3 (9.6–11.1) and 6.1 (5.8–6.4) among patients aged 18–34, 35–49, 50–59, 60–69, 70–79 and &gt;80 years, respectively. Conclusion Despite low cardiovascular risk profile AF still carries high risk for developing incidental HF in particular during the first observation year with increasing tendency along with increasing age. Younger patients with AF and without other cardiovascular comorbidities had more than 100 times higher relative risk to develop HF within one year when compared to matched controls. FUNDunding Acknowledgement Type of funding sources: None.

Continuous intravenous dobutamine is associated with an increased risk of death in patients with advanced heart failure: Insights from the Flolan International Randomized Survival Trial (FIRST)

1999 ◽  
Vol 138 (1) ◽  
pp. 78-86 ◽  
Author(s):  
Christopher M. O'Connor ◽  
Wendy A. Gattis ◽  
Barry F. Uretsky ◽  
Kirkwood F. Adams ◽  
Steven E. McNulty ◽  
...  
Keyword(s):  
Heart Failure ◽  
Advanced Heart Failure ◽  
Risk Of Death ◽  
Increased Risk

scholarly journals Short-term and one-year prognosis of diabetic patients with a first-ever myocardial infarction

Medicina ◽  
2007 ◽  
Vol 43 (7) ◽  
pp. 555 ◽  
Author(s):  
Lina Jančaitytė ◽  
Daiva Rastenytė
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Acute Heart Failure ◽  
Female Gender ◽  
Ischemic Heart ◽  
Diabetic Patients ◽  
Risk Of Death ◽  
One Year

Objectives. To clarify the importance of clinical features and changes in the first electrocardiogram in 28-day and 1-year mortality in patients with diabetes. Material and methods. Men and women of Kaunas city aged 25–64 years with the first-ever myocardial infarction during 1983–1992 and with the first electrocardiogram were enrolled in the study. Electrocardiograms were coded using the WHO MONICA Project Protocol criteria and the Minnesota Code. The Kaunas Ischemic Heart Disease Register was the source of data; deaths from ischemic heart disease were identified via death register. Results. Diabetes was diagnosed in 124 patients: 65 (52.4%) men and 59 (47.6%) women. The 28-day (P=0.01) and 1-year mortality rates (P<0.001) were higher in diabetic than in nondiabetic patients with myocardial infarction. Among diabetic patients, who died during 28 days or one year, myocardial infarction was more often complicated by acute heart failure, and changes in ECG were more often detected than among those who were alive. Female gender (RR=30.2, P=0.02) was associated with an increased risk of death from a first-ever myocardial infarction during the first 28 days, while acute heart failure (RR=4.48, P=0.01) and anterior location of Q wave in the first ECG (RR=2.71, P=0.04) increased the risk of death from ischemic heart disease during one year after a first-ever myocardial infarction. Conclusions. Acute heart failure and Q-wave in derivations of the first electrocardiogram reflecting anterior site of myocardial infarction increased the risk of death from ischemic heart disease during the first year, and female gender – during the first 28 days in diabetic patients with myocardial infarction.

scholarly journals Incidence and impact on prognosis of heart failure in Middle Eastern patients undergoing percutaneous coronary interventions

2017 ◽  
Vol 8 (2) ◽  
pp. 20-28
Author(s):  
Ayman J Hammoudeh ◽  
Dalal Al-Natour ◽  
Yousef Khader ◽  
Imad A Alhaddad ◽  
Ramzi Tabbalat ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Stay ◽  
Middle Eastern ◽  
Adverse Outcomes ◽  
Cardiac Biomarkers ◽  
Prior History ◽  
Cardiac Mortality ◽  
Risk Of Death ◽  
Percutaneous Coronary ◽  
One Year

Background:  Heart failure (HF) is a serious complication of percutaneous coronary intervention (PCI) that adversely impacts survival and quality of life.  Aims and Objectives: We sought to study the incidence of HF in Middle Eastern patients undergoing PCI and its impact on prognosis.Materials and Methods: The first Jordanian PCI Registry was a prospective multicenter study of PCI patients who were followed for one year. Patients who developed heart failure during hospitalization had their clinical and coronary angiographic profiles and adverse outcomes compared with those in patients who did not develop HF.  Results: Of 2425 patients who had PCI, 194 (8.0%) developed HF during the hospital stay. Compared with patients who did not develop HF, those who developed HF were more likely to have diabetes mellitus, prior history of myocardial infarction (MI), elevated levels of cardiac biomarkers, ST-segment elevation MI and multivessel or left anterior descending coronary artery disease (all p values<0.05). Cardiac mortality was significantly higher among patients who developed HF compared with those who did not (5.2% vs. 0.4%; p<0.0001) and at one year (11.2% vs. 1.2%; p<0.001). Multivariate analysis showed that HF during hospital stay was an independent predictor of one-year cardiac mortality (Odds ratio 6.1, 95% CI 3.3-11.1, p<0.001) . At one year, readmission rates for HF and ACS were higher among HF patients.  Conclusions: Certain clinical and angiographic features were associated with higher incidence of HF among Middle Eastern patients who undergo PCI. HF was associated with higher risk of death and other adverse cardiac events during hospital stay and one year of follow up.Asian Journal of Medical Sciences Vol.8(2) 2017 20-28

scholarly journals Performance and Accuracy of Natural Language Processing to Identify Disease Aetiology from Non-Structured Cardiac MRI Electronic Medical Record Reports

2020 ◽  
Keyword(s):  
Heart Failure ◽  
Natural Language Processing ◽  
Natural Language ◽  
Language Processing ◽  
Cardiac Mri ◽  
Prediction Models ◽  
Interstitial Fibrosis ◽  
Survival Prediction ◽  
Free Text ◽  
Imaging Findings

The utility of cardiac MRI (CMR) in patients with heart failure has been well demonstrated and continues to expand as MRI techniques evolve. Its main superiorities in this patient population include: accurate and reproducible quantification of ventricular systolic functions; enhanced discrimination of abnormal myocardial tissue characteristics (i.e., oedema, interstitial fibrosis, and replacement fibrosis); and assessment of valvular function/morphology, endocardium and pericardium in a single scan.1,2 CMR is now an essential part of the diagnosis of various types of heart failure, including cardiac amyloidosis, cardiac sarcoidosis, myocarditis, arrhythmogenic right ventricular cardiomyopathy, and iron overload cardiomyopathy. CMR findings also have prognostic implications, such as in hypertrophic cardiomyopathy.1,2These have resulted in an increasing demand and utility of CMR in routine clinical practice. However, the synthesis of imaging findings into a final or differential diagnosis is typically written in free-text, resulting in difficulties with accurately categorising cardiomyopathy types by generic query algorithms. Natural language processing (NLP) is an analytical method that has been used to develop computer-based algorithms that handle and transform natural linguistics so that the information can be used for computation.3 It enables gathering and combining of information extracted from various online databases, and helps create solid outputs that could serve as research endpoints, including sample identification and variable collection. In the field of imaging, NLP may also have several clinical applications, such as highlighting and classifying imaging findings, generating follow-up recommendations, imaging protocols, and survival prediction models.4

Sign in / Sign up

Export Citation Format

Share Document