The importance of re-evaluating the risk score in heart failure patients: An analysis from the Metabolic Exercise Cardiac Kidney Indexes (MECKI) score database
Articolo
Data di Pubblicazione:
2023
Citazione:
The importance of re-evaluating the risk score in heart failure patients: An analysis from the Metabolic Exercise Cardiac Kidney Indexes (MECKI) score database / B. Pezzuto, M. Piepoli, A. Galotta, S. Sciomer, D. Zaffalon, D. Filomena, C. Vignati, M. Contini, M. Alimento, N. Baracchini, A. Apostolo, P. Palermo, M. Mapelli, E. Salvioni, C. Carriere, M. Merlo, S. Papa, J. Campodonico, R. Badagliacca, G. Sinagra, P. Agostoni. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 0167-5273. - 376:(2023 Apr 01), pp. 90-96. [10.1016/j.ijcard.2023.01.069]
Abstract:
Background: The role of risk scores in heart failure (HF) management has been highlighted by international guidelines. In contrast with HF, which is intrinsically a dynamic and unstable syndrome, all its prognostic studies have been based on a single evaluation. We investigated whether time-related changes of a well-recognized risk score, the MECKI score, added prognostic value. MECKI score is based on peak VO2, VE/VCO2 slope, Na+, LVEF, MDRD and Hb. Methods: A multi-centre retrospective study was conducted involving 660 patients who performed MECKI re-evaluation at least 6 months apart. Based on the difference between II and I evaluation of MECKI values (MECKI II - MECKI I = ∆ MECKI) the study population was divided in 2 groups: those presenting a score reduction (∆ MECKI <0, i.e. clinical improvement), vs. patients presenting an increase (∆ MECKI >0, clinical deterioration). Results: The prognostic value of MECKI score is confirmed also when re-assessed during follow-up. The group with improved MECKI (366 patients) showed a better prognosis compared to patients with worsened MECKI (294 patients) (p < 0.0001). At 1st evaluation, the two groups differentiated by LVEF, VE/VCO2 slope and blood Na+ concentration, while at 2nd evaluation they differentiated in all 6 parameters considered in the score. The patients who improved MECKI score, improved in all components of the score but hemoglobin, while patients who worsened the score, worsened all parameters. Conclusions: This study shows that re-assessment of MECKI score identifies HF subjects at higher risk and that score improvement or deterioration regards several MECKI score generating parameters confirming the holistic background of HF.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Exercise capacity; Heart failure; Hemoglobin; Prognosis; Renal function; Risk stratification
Elenco autori:
B. Pezzuto, M. Piepoli, A. Galotta, S. Sciomer, D. Zaffalon, D. Filomena, C. Vignati, M. Contini, M. Alimento, N. Baracchini, A. Apostolo, P. Palermo, M. Mapelli, E. Salvioni, C. Carriere, M. Merlo, S. Papa, J. Campodonico, R. Badagliacca, G. Sinagra, P. Agostoni
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