Development and validation of a prognostic score integrating remote heart failure symptoms and clinical variables in mortality risk prediction after myocardial infarction: the PragueMi score

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F24%3A00085087" target="_blank" >RIV/00023001:_____/24:00085087 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11110/24:10480221 RIV/00216208:11120/24:43927102

Result on the web

<a href="https://academic.oup.com/eurjpc/article/31/14/1713/7630700#486058673" target="_blank" >https://academic.oup.com/eurjpc/article/31/14/1713/7630700#486058673</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/eurjpc/zwae114" target="_blank" >10.1093/eurjpc/zwae114</a>

Result language

angličtina

Original language name

Development and validation of a prognostic score integrating remote heart failure symptoms and clinical variables in mortality risk prediction after myocardial infarction: the PragueMi score

Original language description

Aims While heart failure (HF) symptoms are associated with adverse prognosis after myocardial infarction (MI), they are not routinely used for patients&apos; stratification. The primary objective of this study was to develop and validate a score to predict mortality risk after MI, combining remotely recorded HF symptoms and clinical risk factors, and to compare it against the guideline-recommended Global Registry of Acute Coronary Events (GRACE) score.Methods and results A cohort study design using prospectively collected data from consecutive patients hospitalized for MI at a large tertiary heart centre between June 2017 and September 2022 was used. Data from 1135 patients (aged 64 +/- 12 years, 26.7% women), were split into derivation (70%) and validation cohort (30%). Components of the 23-item Kansas City Cardiomyopathy Questionnaire and clinical variables were used as possible predictors. The best model included the following variables: age, HF history, admission creatinine and heart rate, ejection fraction at hospital discharge, and HF symptoms 1 month after discharge including walking impairment, leg swelling, and change in HF symptoms. Based on these variables, the PragueMi score was developed. In the validation cohort, the PragueMi score showed superior discrimination to the GRACE score for 6 months [the area under the receiver operating curve (AUC) 90.1, 95% confidence interval (CI) 81.8-98.4 vs. 77.4, 95% CI 62.2-92.5, P = 0.04) and 1-year risk prediction (AUC 89.7, 95% CI 83.5-96.0 vs. 76.2, 95% CI 64.7-87.7, P = 0.004).Conclusion The PragueMi score combining HF symptoms and clinical variables performs better than the currently recommended GRACE score. The prognosis of patients after myocardial infarction is heterogeneous. Thus, risk stratification is needed to identify and intervene patients at increased risk. While heart failure (HF) symptoms are associated with adverse prognosis, they are not used for patients&apos; stratification. We have developed and internally validated the PragueMi score, which integrates clinical risk factors at the time of hospitalization and HF symptoms determined remotely by a questionnaire 1 month after hospital discharge. PragueMi score was able to better stratify patients&apos; risk as compared with the currently recommended Global Registry of Acute Coronary Events score. Graphical Abstract

Czech name

—

Czech description

—

Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

Result was created during the realization of more than one project. More information in the Projects tab.

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year

2024

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

European journal of preventive cardiology

ISSN

2047-4873

e-ISSN

2047-4881

Volume of the periodical

31

Issue of the periodical within the volume

14

Country of publishing house

GB - UNITED KINGDOM

Number of pages

8

Pages from-to

1713-1720

UT code for WoS article

001194372800001

EID of the result in the Scopus database

2-s2.0-85207321156