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 language | English |
|---|---|
| Pages (from-to) | 756-765 |
| Number of pages | 10 |
| Journal | Journal of Heart and Lung Transplantation |
| Volume | 12 |
| Issue number | 5 |
| Publication status | Published - 1993 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
- Transplantation
Cite this
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 journal › Article
}
TY - JOUR
T1 - Predictors of prognosis in patients awaiting heart transplantation
AU - Campana, C.
AU - Gavazzi, A.
AU - Berzuini, C.
AU - Larizza, C.
AU - Marioni, R.
AU - D'Armini, A.
AU - Pederzolli, N.
AU - Martinelli, L.
AU - Vigano, M.
PY - 1993
Y1 - 1993
N2 - 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.
AB - 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.
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UR - http://www.scopus.com/inward/citedby.url?scp=0027423187&partnerID=8YFLogxK
M3 - Article
C2 - 8241212
AN - SCOPUS:0027423187
VL - 12
SP - 756
EP - 765
JO - Journal of Heart and Lung Transplantation
JF - Journal of Heart and Lung Transplantation
SN - 1053-2498
IS - 5
ER -