Abstract 15666: The Mecki Score: A More Accurate Prognostic Tool in Patients With Heart Failure. A Multicenter Comparison With Shfm and Hfss in a Large Cohort of Patients
Introduction: Heart failure (HF) prognostication is a challenging medical judgment. Many multiparametric risk models have been proposed but available algorithms have multiple limitations. Cardiopulmonary exercise test (CPET) is an accurate tool for risk stratification but it needs to be integrated into clinical practice. Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score is a simple 6-variables (VO2, VE/VCO2, Hemoglobin, Sodium, MDRD, ejection fraction (EF)) score validated for HF with reduced EF (HFrEF).
Hypothesis: We evaluated the prognostic value of MECKI Score in a multicentric large population of HFrEF compared with two of the most-used and available scores: Heart Failure Survival Score (HFSS) and Seattle Heart Failure Model (SHFM).
Methods: We collected data on clinically stable patients with HFrEF (EF < 40%) admitted in 23 HF units. We recorded clinical history, physical examination, blood sample, ECG, transthoracic echocardiogram, CPET. We compared the prognostic accuracy of MECKI score, HFSS and SHFM at 2 and 4 years follow-up for the combined endpoint of cardiovascular (CV) death, and urgent cardiac transplant or ventricular assist device. Receiver Operating Characteristic (ROC) curves were compared with DeLong method.
Results: Study cohort consisted of 6112 (mean age 61.3±12.6 years) consecutive HFrEF patients, prospectively followed in 23 Italian HF centers with a median follow-up of 3.67 years (1341 days, interquartile range 630-2353 days). A total of 931 CV deaths, 160 heart transplantations and 12 ventricular assist device were recorded. The prognostic accuracy of MECKI score was significantly superior compared to SHFM and HFSS at 2 and 4 years follow-up (Fig. 1).
Conclusions: In a large database of HF patients in stable clinical condition and capable to perform a cardiopulmonary exercise test, the prognostic accuracy of the MECKI score is superior at 2 and 4 years follow-up compared to HFSS and SHFM.
Author Disclosures: M. Mapelli: None. S. Paolillo: None. A. Scardovi: None. U. Corrà: None. M. Emdin: None. R. Lagioia: None. M. Metra: None. G. Limongelli: None. G. Sinagra: None. E. Salvioni: None. P. Agostoni: None.
- © 2016 by American Heart Association, Inc.