TY - JOUR
T1 - The metabolic exercise test data combined with Cardiac and Kidney Indexes (MECKI) score and prognosis in heart failure. A validation study
AU - Corra', Ugo
AU - Agostoni, Piergiuseppe
AU - Giordano, Andrea
AU - Cattadori, Gaia
AU - Battaia, Elisa
AU - La Gioia, Rocco
AU - Scardovi, Angela Beatrice
AU - Emdin, Michele
AU - Metra, Marco
AU - Sinagra, Gianfranco
AU - Limongelli, Giuseppe
AU - Raimondo, Rosa
AU - Re, Federica
AU - Guazzi, Marco
AU - Belardinelli, R.
AU - Parati, Gianfranco
AU - Magrì, Damiano
AU - Fiorentini, Cesare
AU - Cicoira, Mariantonietta
AU - Salvioni, Elisabetta
AU - Giovannardi, Marta
AU - Veglia, Fabrizio
AU - Mezzani, Alessandro
AU - Scrutinio, Domenico
AU - Di Lenarda, Andrea
AU - Ricci, Roberto
AU - Apostolo, Anna
AU - Iorio, Anna Maria
AU - Paolillo, Stefania
AU - Palermo, Pietro
AU - Contini, Mauro Camillo
AU - Vassanelli, Corrado
AU - Passino, Claudio
AU - Giannuzzi, Pantaleo
AU - Piepoli, Massimo F.
PY - 2016/1/15
Y1 - 2016/1/15
N2 - Background 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.
AB - Background 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.
KW - Heart failure
KW - Prognosis, score
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U2 - 10.1016/j.ijcard.2015.11.075
DO - 10.1016/j.ijcard.2015.11.075
M3 - Article
VL - 203
SP - 1067
EP - 1072
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -