Heart failure with preserved ejection fraction: Calculating the risk of future heart failure events and death
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Key result
HALO score predicts ~113% higher HFpEF mortality, driven by NYHA class and recurrent HF hospitalizations.
- HR 2.13
- 95% CI 1.30-3.47
- P=0.002
- n=422
Why the study?
The authors sought to develop a clinical model to identify heart failure patients with preserved ejection fraction at highest risk for acute heart failure events or death.
Population
Patients with HFpEF
Design
Clinical risk prediction model development study
Authors
Discussion
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Member takes
Implication
May aid mortality risk stratification in HFpEF; hypothesis-generating and requires prospective validation.
Study Design
Type
Observational (n=422)
Multicenter
No
Structured PICO
P
Population
422 consecutive patients with heart failure with preserved ejection fraction (HFpEF) (LVEF ≥50%, NT-proBNP ≥220 pg/ml, clinical signs/symptoms, evidence of diastolic LV dysfunction), plus an external validation cohort of 75 independent patients.
O
Outcome
Overall survival within the follow-up periodhard clinical
Main Result
Effect estimate: HR 2.13 (95% CI 1.30-3.47)
p-value: p=0.002
The HALO score, incorporating clinical variables like NYHA class and prior hospitalizations, effectively identifies HFpEF patients at high risk for mortality and recurrent heart failure events.
Limitations
- Single-center nature cannot exclude center-specific bias
- Lack of serially collected echocardiographic or functional tests over time
- Small validation cohort size limits reliability due to sampling variability
- Unclear if identified high-risk patients will benefit from intensified therapy
- Single-center nature with potential center-specific bias
- Lack of serially collected echocardiographic or functional follow-up data
- Limited number of variables integrated into the model
- Small validation cohort limiting reliability due to sampling variability
Cite This Study
Schrutka et al. (2022) conducted an observational in Heart failure with preserved ejection fraction (HFpEF) (n=422). HALO (Hfpef survivAL hOspitalization) score was evaluated on Overall survival (all-cause mortality) (HR 2.13, 95% CI 1.30-3.47, p=0.002). The HALO score, driven strongly by NYHA class and recurrent HF hospitalizations, significantly predicted overall survival in patients with HFpEF (HR 2.13).
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