The metabolic exercise test data combined with Cardiac And Kidney Indexes (MECKI) score and prognosis in heart failure. A validation study

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• 作者：Ugo Corrà ; ^a ; ^{ucorra@fsm.it" class="auth_mail" title="E-mail the corresponding author} ; Piergiuseppe Agostoni^b ; ^c ; Andrea Giordano^d ; Gaia Cattadori^b ; Elisa Battaia^b ; ^e ; Rocco La Gioia^f ; Angela B. Scardovi^g ; Michele Emdin^h ; Marco Metraⁱ ; Gianfranco Sinagra^j ; Giuseppe Limongelli^k ; Rosa Raimondo^l ; Federica Re^m ; Marco Guazziⁿ ; Romualdo Belardinelli^o ; Gianfranco Parati^p ; Damiano Magrì ; ^q ; Cesare Fiorentini^b ; ^c ; Mariantonietta Cicoira^e ; Elisabetta Salvioni^b ; Marta Giovannardi^b ; Fabrizio Veglia^b ; Alessandro Mezzani^a ; Domenico Scrutinio^f ; Andrea Di Lenarda^r ; Roberto Ricci^g ; Anna Apostolo^b ; Anna Maria Iorio^k ; Stefania Paolillo^s ; Pietro Palermo^b ; Mauro Contini^b ; Corrado Vassanelli^e ; Claudio Passino^h ; ^t ; Pantaleo Giannuzzi^a ; Massimo F. Piepoli^u ; on behalf of the MECKI score research group
• 关键词：Heart failure ; Prognosis ; score
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：15 January 2016
• 年：2016
• 卷：203
• 期：Complete
• 页码：1067-1072
• 全文大小：296 K

文摘

The Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score is a prognostic model to identify heart failure (HF) patients at risk for cardiovascular mortality (CVM) and urgent heart transplantation (uHT) based on 6 routine clinical parameters: hemoglobin, sodium, kidney function by the Modification of Diet in Renal Disease (MDRD) equation, left ventricle ejection fraction (LVEF), percentage of predicted peak oxygen consumption (VO2) and VE/VCO2 slope.

Objectives

MECKI score must be generalizable to be considered useful: therefore, its performance was validated in a new sequence of HF patients.

Methods

Both the development (MECKI-D) and the validation (MECKI-V) cohorts were composed of consecutive HF patients with LVEF < 40% able to perform a symptom-limited cardiopulmonary exercise testing. The CVM or uHT rates were analyzed at one, two and three years in both cohorts: all patients with a censoring time shorter than the scheduled follow-up were excluded, while those with events occurring after 1, 2 and 3 years were considered as censored.

Results

MECKI-D and MECKI-V consisted of 2009 and 992 patients, respectively. MECKI-V patients had a higher LVEF, higher peak VO2 and lower VE/VCO2 slope, higher prescription of beta-blockers and device therapy: after the 3-year follow-up, CVM or uHT occurred in 206 (18%) MECKI-D and 44 (13%) MECKI-V patients (p < 0.000), respectively. MECKI-V AUC values at one, two and three years were 0.81 ± 0.04, 0.76 ± 0.04, and 0.80 ± 0.03, respectively, not significantly different from MECKI-D.

Conclusions

MECKI score preserves its predictive ability in a HF population at a lower risk.