Abstract 13317: Validation of the Mortality Risk Stratification Models for Cardiovascular Disease
Background: Risk stratification model is an effective tool for the management of cardiovascular diseases. Although several risk scores were reported, the relevance and superiority of the predictive models have not been fully validated in an independent and non-clinical trail-based population.
Methods: We studied the consecutive 3,984 in-patients in our institution between April 2004 and December 2009. Risk scores were calculated for each patient with the established models, including (a) the American Heart Association Get With the Guidelines – Heart Failure risk score (GWTG), (b) the Acute Decompensated Heart Failure National Registry regression model score (ADHERE), (c) Seattle Heart Failure Model score (SHFM), (d) Health Aging and Body Composition Heart Failure Score (ABC), and (e) Framingham risk score. The predictive ability for mortality due to cardiovascular disease was assessed by calculating area under the receiver operating characteristic curve (AUC) in each model.
Results: The mean age of the patients was 61.9±15.9 [SD] years (range, 15 to 94) and 64% were male. The patients with NYHA classification (I, II, II, and IV) were distributed in 50, 26, 16, and 8%, respectively. During the follow-up period after admission (509±521 days), cardiac death occurred in 160 (4%) patients including 72 in-hospital deaths (1.8%). GWTG, ADHERE, and SHFM risk scores showed a significantly higher AUC (0.752, 0.752, and 0.750, respectively) than ABC and Framingham score (0.635 and 0.528, respectively) (all P<0.05). SHFM demonstrated the highest prognostic value for 1 and 2-year mortalities, whereas AUC of GWTG and ADHERE models were comparable with different follow-up durations (Table).
Conclusion: These results suggest that GWTG, ADHERE and SHFM risk scores have similar predictive values for mortality risk stratification in patients with cardiovascular disease and that SHFM may be more useful than other models for prediction of short term outcome at 1∼2-year follow-up.
- © 2010 by American Heart Association, Inc.