Exploring the Prognostic Performance of MECKI Score in Heart Failure Patients with Non-Valvular Atrial Fibrillation Treated with Edoxaban
Articolo
Data di Pubblicazione:
2024
Citazione:
Exploring the Prognostic Performance of MECKI Score in Heart Failure Patients with Non-Valvular Atrial Fibrillation Treated with Edoxaban / M. Mapelli, I. Mattavelli, E. Salvioni, N. Capra, A. Bonomi, G. Cattadori, B. Pezzuto, J. Campodonico, A. Piotti, A. Nava, M. Piepoli, D. Magrì, S. Paolillo, U. Corrà, R. Raimondo, R. Lagioia, C. Vignati, R. Badagliacca, P. Perrone Filardi, M. Senni, M. Correale, M. Cicoira, M. Metra, M. Guazzi, G. Limongelli, G. Parati, F. De Martino, F. Bandera, M. Bussotti, F. LO RE, C.M. Lombardi, A.B. Scardovi, S. Sciomer, A. Passantino, M. Emdin, C. Santolamazza, E. Perna, C. Passino, G. Sinagra, P. Agostoni. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 13:1(2024), pp. 94.1-94.10. [10.3390/jcm13010094]
Abstract:
Introduction: Risk stratification in heart failure (HF) is essential for clinical and therapeutic
management. The Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI)
score is a validated prognostic model for assessing cardiovascular risk in HF patients with reduced
ejection fraction (HFrEF). From the validation of the score, the prevalence of HF patients treated with
direct oral anticoagulants (DOACs), such as edoxaban, for non-valvular atrial fibrillation (NVAF)
has been increasing in recent years. This study aims to evaluate the reliability of the MECKI score
in HFrEF patients treated with edoxaban for NVAF. Materials and Methods: This study included
consecutive outpatients with HF and NVAF treated with edoxaban (n = 83) who underwent a
cardiopulmonary exercise test (CPET). They were matched by propensity score with a retrospective
group of HFrEF patients with NVAF treated with vitamin K antagonists (VKAs) from the MECKI
score registry (n = 844). The study endpoint was the risk of cardiovascular mortality, urgent heart
transplantation, or Left Ventricle Assist Device (LVAD) implantation. Results: Edoxaban patients were
treated with a more optimized HF therapy and had different clinical characteristics, with a similar
MECKI score. After propensity score, 77 patients treated with edoxaban were successfully matched
with the MECKI-VKA control cohort. In both groups, MECKI accurately predicted the composite
endpoint with similar area under the curves (AUC = 0.757 vs. 0.829 in the MECKI-VKA vs. edoxaban-
treated group, respectively, p = 0.452). The two populations’ survival appeared non-significantly
different at the 2-year follow-up. Conclusions: this study confirms the prognostic accuracy of the
MECKI score in HFrEF patients with NVAF treated with edoxaban, showing improved predictive
power compared to VKA-treated patients.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
NVAF; heart failure (HF); prognosis; cardiopulmonary exercise testing (CPET); atrial fibrillation; edoxaban; DOACs; anticoagulants
Elenco autori:
M. Mapelli, I. Mattavelli, E. Salvioni, N. Capra, A. Bonomi, G. Cattadori, B. Pezzuto, J. Campodonico, A. Piotti, A. Nava, M. Piepoli, D. Magrì, S. Paolillo, U. Corrà, R. Raimondo, R. Lagioia, C. Vignati, R. Badagliacca, P. Perrone Filardi, M. Senni, M. Correale, M. Cicoira, M. Metra, M. Guazzi, G. Limongelli, G. Parati, F. De Martino, F. Bandera, M. Bussotti, F. LO RE, C.M. Lombardi, A.B. Scardovi, S. Sciomer, A. Passantino, M. Emdin, C. Santolamazza, E. Perna, C. Passino, G. Sinagra, P. Agostoni
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