Predictors of prognosis in patients awaiting heart transplantation

C. Campana, A. Gavazzi, C. Berzuini, C. Larizza, R. Marioni, A. D'Armini, N. Pederzolli, L. Martinelli, M. Vigano

Research output: Contribution to journalArticle

Abstract

Patients enrolled in a clinical heart transplantation program were evaluated to identify the predictors of prognosis in patients with advanced heart disease and to optimize timing of heart transplantation. Three hundred eighty-eight subjects were consecutively evaluated from 1985 through 1989. One hundred eighty-four patients (47.5%) had dilated cardiomyopathy; 164 patients (42.2%) had ischemic heart disease; 34 patients (8.8%) had valvular heart disease, and six patients (1.5%) had miscellaneous disorders. In each patient, 45 different parameters were considered. During follow-up (mean, 8.4 months) 166 patients underwent heart transplantation; 99 patients died (heart failure, 66 patients; sudden death, 26 patients; thromboembolism, two patients; noncardiac causes, five patients). The actuarial survival was 83% at 3 months, 77% at 6 months, 73% at 9 months, 70% at 1 year, and 59% at 2 years. The median survival time was 28 months. Analysis by Cox proportional hazard regression model revealed seven independent and significant prognostic factors: etiology (p <0.05), NYHA class (p <0.05), third heart sound (p <0.05), diastolic pulmonary artery pressure (p <0.05), pulmonary wedge pressure (p <0.01), mean systemic blood pressure (p <0.05), and cardiac output (p <0.05). Cox's analysis allows the computation of patient-specific curves for predictions of residual survival time at any moment during follow- up. Moreover it can be used to calculate a simple prognostic index, which enables stratification of the patient population into three risk classes: patients at high (n = 105), intermediate (n = 160) and low (n = 123) risk of early death. Pairwise comparisons of survival between the classes were significant at 1% level.

Original languageEnglish
Pages (from-to)756-765
Number of pages10
JournalJournal of Heart and Lung Transplantation
Volume12
Issue number5
Publication statusPublished - 1993

Fingerprint

Heart Transplantation
Survival
Heart Sounds
Heart Valve Diseases
Pulmonary Wedge Pressure
Thromboembolism
Dilated Cardiomyopathy
Sudden Death
Proportional Hazards Models
Cardiac Output
Pulmonary Artery
Myocardial Ischemia
Heart Diseases

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

Cite this

Campana, C., Gavazzi, A., Berzuini, C., Larizza, C., Marioni, R., D'Armini, A., ... Vigano, M. (1993). Predictors of prognosis in patients awaiting heart transplantation. Journal of Heart and Lung Transplantation, 12(5), 756-765.

Predictors of prognosis in patients awaiting heart transplantation. / Campana, C.; Gavazzi, A.; Berzuini, C.; Larizza, C.; Marioni, R.; D'Armini, A.; Pederzolli, N.; Martinelli, L.; Vigano, M.

In: Journal of Heart and Lung Transplantation, Vol. 12, No. 5, 1993, p. 756-765.

Research output: Contribution to journalArticle

Campana, C, Gavazzi, A, Berzuini, C, Larizza, C, Marioni, R, D'Armini, A, Pederzolli, N, Martinelli, L & Vigano, M 1993, 'Predictors of prognosis in patients awaiting heart transplantation', Journal of Heart and Lung Transplantation, vol. 12, no. 5, pp. 756-765.
Campana C, Gavazzi A, Berzuini C, Larizza C, Marioni R, D'Armini A et al. Predictors of prognosis in patients awaiting heart transplantation. Journal of Heart and Lung Transplantation. 1993;12(5):756-765.
Campana, C. ; Gavazzi, A. ; Berzuini, C. ; Larizza, C. ; Marioni, R. ; D'Armini, A. ; Pederzolli, N. ; Martinelli, L. ; Vigano, M. / Predictors of prognosis in patients awaiting heart transplantation. In: Journal of Heart and Lung Transplantation. 1993 ; Vol. 12, No. 5. pp. 756-765.
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