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AHEAD score - Long-term risk classification in acute heart failure

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ŠPINAR Jindřich JARKOVSKÝ Jiří ŠPINAROVÁ Lenka MEBAZAA Alexandre GAYAT Etienne VÍTOVEC Jiří LINHART Ales WIDIMSKY Petr MIKLIK Roman ZEMAN Kamil BELOHLAVEK Jan MALEK Filip FELŠŐCI Marián KETTNER Jiri OSTADAL Petr CIHALIK Cestmir VACLAVIK Jan TABORSKY Miloš DUŠEK Ladislav LITTNEROVÁ Simona PAŘENICA Jiří

Rok publikování 2016
Druh Článek v odborném periodiku
Časopis / Zdroj International Journal of Cardiology
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Doi http://dx.doi.org/10.1016/j.ijcard.2015.08.187
Obor Kardiovaskulární nemoci včetně kardiochirurgie
Klíčová slova Acute heart failure; Prognosis; Model; Mortality
Popis Background: The role of co-morbidities in the prognosis of patients hospitalized for AHFwas examined using the AHEAD (A — atrial fibrillation, H — haemoglobin b 130 g/l for men and 120 g/l for women (anaemia), E — elderly (age N 70 years), A — abnormal renal parameters (creatinine N 130 micromol/l), D — diabetes mellitus) scoring system. Methods: AHEAD — multicentre prospective Czech registry of AHF patients; GREAT registry — international cohort of AHF patients. Data from 5846 consecutive patients hospitalized for AHF (AHEAD registry; derivation cohort) were analysed to build the AHEAD score. Each risk factor of the AHEAD score was counted as 1 point. The model was validated externally using an international cohort of similar patients in the GREAT registry (6315). Results:Main outcome was one year all-cause mortality. The mean age of patientswas 72±12 years,with 61.6% of patients aged N70 years; 43.4% were women. Atrial fibrillation was present in 30.7%, anaemia in 38.2%, creatinine N130mmol/l (abnormal renal parameters) in 30.1%, and diabetes mellitus in 44.0%. The mean AHEAD score was 2.1. In patients with AHEAD scores of 0–5, the one-year mortality rates were 13.6%, 23.4%, 32.0%, 41.1%, 47.7%, and 58.2%, respectively (p b 0.001), and the 90 month mortality rates were 35.1%, 57.3%, 73.5%, 84.8%, 88.0%, and 91.7%, respectively (p b 0.001). Conclusion: The AHEAD is a simple scoring system based on the analysis of co-morbidities for the estimation of the short and long term prognosis of patients hospitalized for AHF.
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