Abstract 13205: Validation of a Risk Score for Hospitalization for Heart Failure in Atrial Fibrillation Patients: From the Fushimi Af Registry
Purpose: Heart failure (HF) is the important comorbidity associated with atrial fibrillation (AF) and related to poor prognosis. Previous study showed H2ARDD score (H2: Heart disease (valvular heart disease, coronary heart disease, myocardial infarction, and cardiomyopathy), A: Anemia (hemoglobin<11 g/dl), R: Renal dysfunction (estimated glomerular filtration rate<60 ml/min/m2), D: Diabetes mellitus, D: Diuretics) efficiently identify the population of patients with AF at high risk of HF events. We investigated the effectiveness of H2ARDD score in one-year outcomes of the Fushimi AF registry.
Methods: The Fushimi AF Registry, a community-based prospective survey, was designed to enroll all of the AF patients in Fushimi-ku, Kyoto, Japan. Fushimi-ku is densely populated with a total population of 283,000, and is assumed to represent a typical urban community in Japan. At present, we have enrolled 3,821 patients (1.3% of total population) from March 2011 to April 2014. One-year follow-up was completed in 3,189 patients as of April 2014, and we obtained H2ARDD score in 2,934 patients (59.6% men; mean age, 74±11 years; mean CHADS2 score, 2.1±1.3).
Results: Mean H2ARDD score was 1.8±1.6 and almost half of the patients showed score 0 or 1 (score 0, 23.8%; score 1, 24.6%). During one-year follow-up, 154 (5.3%) patients had HF events (32 (1.1%) cardiovascular (CV) death, and 123 (4.2%) hospitalization for HF). The incidence of HF events and HF hospitalization increased as H2ARDD score increased (p<0.0001 and p<0.0001, respectively; figure). Receiver operating characteristic analysis showed H2ARDD score had acceptable discrimination performance (C-statistics 0.74), and H2ARDD score was a significant predictor for HF events in a Cox proportional hazard analysis (hazard ratio, 1.69; 95% confidence interval, 1.53-4.85; p<0.0001).
Conclusion: H2ARDD score is useful in identifying high risk patients for HF events and HF hospitalization in Japanese patients with AF.
Author Disclosures: M. Iguchi: None. H. Ogawa: None. N. Masunaga: None. M. Ishii: None. M. Esato: None. Y. Chun: None. H. Wada: None. K. Hasegawa: None. M. Abe: None. M. Akao: Research Grant; Modest; Bayer Healthcare, Daiichi-Sankyo, Sanofi-Aventis, Takeda Pharmaceutical. Research Grant; Significant; Boehringer Ingelheim, Pfizer, Bristol-Myers Squibb. Honoraria; Modest; Boehringer Ingelheim. Honoraria; Significant; Pfizer, Bristol-Myers Squibb, Bayer Healthcare.
- © 2014 by American Heart Association, Inc.