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

Kód výsledku v 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>

Nalezeny alternativní kódy

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

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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

Název v anglickém jazyce

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

Popis výsledku anglicky

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

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

Výsledek vznikl pri realizaci vícero projektů. Více informací v záložce Projekty.

Návaznosti

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

Rok uplatnění

2024

Kód důvěrnosti údajů

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

Název periodika

European journal of preventive cardiology

ISSN

2047-4873

e-ISSN

2047-4881

Svazek periodika

31

Číslo periodika v rámci svazku

14

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

8

Strana od-do

1713-1720

Kód UT WoS článku

001194372800001

EID výsledku v databázi Scopus

2-s2.0-85207321156