Prognostic impact of MitraScore in elderly Asian patients with heart failure: sub‐analysis of FRAGILE‐HF
Abstract Aims MitraScore is a novel, simple, and manually calculatable risk score developed as a prognostic model for patients undergoing transcatheter edge‐to‐edge repair (TEER) for mitral regurgitation. As its components are considered prognostic in heart failure (HF), we aimed to investigate the...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-04-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.14658 |
| _version_ | 1797242795651497984 |
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| author | Tomohiro Kaneko Nobuyuki Kagiyama Takatoshi Kasai Kentaro Kamiya Hiroshi Saito Kazuya Saito Yuki Ogasahara Emi Maekawa Masaaki Konishi Takeshi Kitai Kentaro Iwata Kentaro Jujo Hiroshi Wada Daichi Maeda Masaru Hiki Tsutomu Sunayama Taishi Dotare Hirofumi Nagamatsu Tetsuya Ozawa Katsuya Izawa Shuhei Yamamoto Naoki Aizawa Akihiro Makino Kazuhiro Oka Shin‐Ichi Momomura Yuya Matsue Tohru Minamino |
| author_facet | Tomohiro Kaneko Nobuyuki Kagiyama Takatoshi Kasai Kentaro Kamiya Hiroshi Saito Kazuya Saito Yuki Ogasahara Emi Maekawa Masaaki Konishi Takeshi Kitai Kentaro Iwata Kentaro Jujo Hiroshi Wada Daichi Maeda Masaru Hiki Tsutomu Sunayama Taishi Dotare Hirofumi Nagamatsu Tetsuya Ozawa Katsuya Izawa Shuhei Yamamoto Naoki Aizawa Akihiro Makino Kazuhiro Oka Shin‐Ichi Momomura Yuya Matsue Tohru Minamino |
| author_sort | Tomohiro Kaneko |
| collection | DOAJ |
| description | Abstract Aims MitraScore is a novel, simple, and manually calculatable risk score developed as a prognostic model for patients undergoing transcatheter edge‐to‐edge repair (TEER) for mitral regurgitation. As its components are considered prognostic in heart failure (HF), we aimed to investigate the usefulness of the MitraScore in HF patients. Methods and results We calculated MitraScore for 1100 elderly patients (>65 years old) hospitalized for HF in the prospective multicentre FRAGILE‐HF study and compared its prognostic ability with other simple risk scores. The primary endpoint was all‐cause deaths, and the secondary endpoints were the composite of all‐cause deaths and HF rehospitalization and cardiovascular deaths. Overall, the mean age of 1100 patients was 80 ± 8 years, and 58% were men. The mean MitraScore was 3.2 ± 1.4, with a median of 3 (interquartile range: 2–4). A total of 326 (29.6%), 571 (51.9%), and 203 (18.5%) patients were classified into low‐, moderate‐, and high‐risk groups based on the MitraScore, respectively. During a follow‐up of 2 years, 226 all‐cause deaths, 478 composite endpoints, and 183 cardiovascular deaths were observed. MitraScore successfully stratified patients for all endpoints in the Kaplan–Meier analysis (P < 0.001 for all). In multivariate analyses, MitraScore was significantly associated with all endpoints after covariate adjustments [adjusted hazard ratio (HR) (95% confidence interval): 1.22 (1.10–1.36), P < 0.001 for all‐cause deaths; adjusted HR 1.17 (1.09–1.26), P < 0.001 for combined endpoints; and adjusted HR 1.24 (1.10–1.39), P < 0.001 for cardiovascular deaths]. The Hosmer–Lemeshow plot showed good calibration for all endpoints. The net reclassification improvement (NRI) analyses revealed that the MitraScore performed significantly better than other manually calculatable risk scores of HF: the GWTG‐HF risk score, the BIOSTAT compact model, the AHEAD score, the AHEAD‐U score, and the HANBAH score for all‐cause and cardiovascular deaths, with respective continuous NRIs of 0.20, 0.22, 0.39, 0.39, and 0.29 for all‐cause mortality (all P‐values < 0.01) and 0.20, 0.22, 0.42, 0.40, and 0.29 for cardiovascular mortality (all P‐values < 0.02). Conclusions MitraScore developed for patients undergoing TEER also showed strong discriminative power in HF patients. MitraScore was superior to other manually calculable simple risk scores and might be a good choice for risk assessment in clinical practice for patients receiving TEER and those with HF. |
| first_indexed | 2024-04-24T18:44:54Z |
| format | Article |
| id | doaj.art-16ae80793b6242d3b149e47ebdcb4bad |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-04-24T18:44:54Z |
| publishDate | 2024-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-16ae80793b6242d3b149e47ebdcb4bad2024-03-27T06:48:04ZengWileyESC Heart Failure2055-58222024-04-011121039105010.1002/ehf2.14658Prognostic impact of MitraScore in elderly Asian patients with heart failure: sub‐analysis of FRAGILE‐HFTomohiro Kaneko0Nobuyuki Kagiyama1Takatoshi Kasai2Kentaro Kamiya3Hiroshi Saito4Kazuya Saito5Yuki Ogasahara6Emi Maekawa7Masaaki Konishi8Takeshi Kitai9Kentaro Iwata10Kentaro Jujo11Hiroshi Wada12Daichi Maeda13Masaru Hiki14Tsutomu Sunayama15Taishi Dotare16Hirofumi Nagamatsu17Tetsuya Ozawa18Katsuya Izawa19Shuhei Yamamoto20Naoki Aizawa21Akihiro Makino22Kazuhiro Oka23Shin‐Ichi Momomura24Yuya Matsue25Tohru Minamino26Department of Cardiovascular Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Rehabilitation, School of Allied Health Science Kitasato University Tokyo JapanDepartment of Rehabilitation Kameda Medical Center Kamogawa JapanDepartment of Rehabilitation The Sakakibara Heart Institute of Okayama Okayama JapanDepartment of Nursing The Sakakibara Heart Institute of Okayama Okayama JapanDepartment of Cardiovascular Medicine Kitasato University School of Medicine Tokyo JapanDivision of Cardiology Yokohama City University Medical Center Yokohama JapanDepartment of Cardiovascular Medicine Kobe City Medical Center General Hospital Kobe JapanDepartment of Rehabilitation Kobe City Medical Center General Hospital Kobe JapanDepartment of Cardiology Nishiarai Heart Center Hospital Tokyo JapanDepartment of Cardiovascular Medicine, Saitama Medical Center Jichi Medical University Shimotsuke JapanDepartment of Cardiovascular Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiology Tokai University School of Medicine Tokyo JapanDepartment of Rehabilitation Odawara Municipal Hospital Odawara JapanDepartment of Rehabilitation Matsui Heart Clinic Saitama JapanDepartment of Rehabilitation Shinshu University Hospital Matsumoto JapanDepartment of Cardiovascular Medicine, Nephrology and Neurology University of the Ryukyus Nishihara JapanDepartment of Rehabilitation Kitasato University Medical Center Kitasato JapanDepartment of Rehabilitation Saitama Citizens Medical Center Saitama JapanDepartment of Cardiovascular Medicine Saitama Citizens Medical Center Saitama JapanDepartment of Cardiovascular Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Medicine Juntendo University Graduate School of Medicine Tokyo JapanAbstract Aims MitraScore is a novel, simple, and manually calculatable risk score developed as a prognostic model for patients undergoing transcatheter edge‐to‐edge repair (TEER) for mitral regurgitation. As its components are considered prognostic in heart failure (HF), we aimed to investigate the usefulness of the MitraScore in HF patients. Methods and results We calculated MitraScore for 1100 elderly patients (>65 years old) hospitalized for HF in the prospective multicentre FRAGILE‐HF study and compared its prognostic ability with other simple risk scores. The primary endpoint was all‐cause deaths, and the secondary endpoints were the composite of all‐cause deaths and HF rehospitalization and cardiovascular deaths. Overall, the mean age of 1100 patients was 80 ± 8 years, and 58% were men. The mean MitraScore was 3.2 ± 1.4, with a median of 3 (interquartile range: 2–4). A total of 326 (29.6%), 571 (51.9%), and 203 (18.5%) patients were classified into low‐, moderate‐, and high‐risk groups based on the MitraScore, respectively. During a follow‐up of 2 years, 226 all‐cause deaths, 478 composite endpoints, and 183 cardiovascular deaths were observed. MitraScore successfully stratified patients for all endpoints in the Kaplan–Meier analysis (P < 0.001 for all). In multivariate analyses, MitraScore was significantly associated with all endpoints after covariate adjustments [adjusted hazard ratio (HR) (95% confidence interval): 1.22 (1.10–1.36), P < 0.001 for all‐cause deaths; adjusted HR 1.17 (1.09–1.26), P < 0.001 for combined endpoints; and adjusted HR 1.24 (1.10–1.39), P < 0.001 for cardiovascular deaths]. The Hosmer–Lemeshow plot showed good calibration for all endpoints. The net reclassification improvement (NRI) analyses revealed that the MitraScore performed significantly better than other manually calculatable risk scores of HF: the GWTG‐HF risk score, the BIOSTAT compact model, the AHEAD score, the AHEAD‐U score, and the HANBAH score for all‐cause and cardiovascular deaths, with respective continuous NRIs of 0.20, 0.22, 0.39, 0.39, and 0.29 for all‐cause mortality (all P‐values < 0.01) and 0.20, 0.22, 0.42, 0.40, and 0.29 for cardiovascular mortality (all P‐values < 0.02). Conclusions MitraScore developed for patients undergoing TEER also showed strong discriminative power in HF patients. MitraScore was superior to other manually calculable simple risk scores and might be a good choice for risk assessment in clinical practice for patients receiving TEER and those with HF.https://doi.org/10.1002/ehf2.14658Heart failureRisk scoreMitraScoreTranscatheter edge‐to‐edge repair |
| spellingShingle | Tomohiro Kaneko Nobuyuki Kagiyama Takatoshi Kasai Kentaro Kamiya Hiroshi Saito Kazuya Saito Yuki Ogasahara Emi Maekawa Masaaki Konishi Takeshi Kitai Kentaro Iwata Kentaro Jujo Hiroshi Wada Daichi Maeda Masaru Hiki Tsutomu Sunayama Taishi Dotare Hirofumi Nagamatsu Tetsuya Ozawa Katsuya Izawa Shuhei Yamamoto Naoki Aizawa Akihiro Makino Kazuhiro Oka Shin‐Ichi Momomura Yuya Matsue Tohru Minamino Prognostic impact of MitraScore in elderly Asian patients with heart failure: sub‐analysis of FRAGILE‐HF ESC Heart Failure Heart failure Risk score MitraScore Transcatheter edge‐to‐edge repair |
| title | Prognostic impact of MitraScore in elderly Asian patients with heart failure: sub‐analysis of FRAGILE‐HF |
| title_full | Prognostic impact of MitraScore in elderly Asian patients with heart failure: sub‐analysis of FRAGILE‐HF |
| title_fullStr | Prognostic impact of MitraScore in elderly Asian patients with heart failure: sub‐analysis of FRAGILE‐HF |
| title_full_unstemmed | Prognostic impact of MitraScore in elderly Asian patients with heart failure: sub‐analysis of FRAGILE‐HF |
| title_short | Prognostic impact of MitraScore in elderly Asian patients with heart failure: sub‐analysis of FRAGILE‐HF |
| title_sort | prognostic impact of mitrascore in elderly asian patients with heart failure sub analysis of fragile hf |
| topic | Heart failure Risk score MitraScore Transcatheter edge‐to‐edge repair |
| url | https://doi.org/10.1002/ehf2.14658 |
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