Key result
The novel Alpha-score demonstrated good discrimination for predicting all-cause mortality and heart transplantation in non-ischemic cardiomyopathy patients with CRT, with a c-statistic of 0.749.
Why the study?
Predictors of mortality and heart failure hospitalization after cardiac resynchronization therapy in non-ischemic cardiomyopathy needed identification to design a prognostic risk score.
Does the Alpha-score accurately predict mortality and heart failure hospitalization in patients with non-ischemic cardiomyopathy receiving CRT?
Cohort (n=422)
No
Does the Alpha-score accurately predict mortality and heart failure hospitalization in patients with non-ischemic cardiomyopathy receiving CRT?
Effect estimate: c-statistic 0.749 (95% CI 0.694-0.804)
p-value: p=<0.001
The novel Alpha-score provides good discrimination for predicting long-term mortality and heart transplantation in patients with non-ischemic cardiomyopathy undergoing CRT.
May support risk stratification in non-ischemic cardiomyopathy CRT patients; leaves open prospective validation before clinical use.
BACKGROUND: Non-ischemic cardiomyopathy (NICM) has been associated with a better left ventricle reverse remodeling response and improved clinical outcomes after cardiac resynchronization therapy (CRT). The aims of our study were to identify the predictors of mortality and heart failure hospitalization in patients treated with CRT and design a risk score for prognosis. METHODS: A cohort of 422 consecutive NICM patients with CRT was retrospectively enrolled between January 2010 and December 2017. The primary endpoint was all-cause mortality and heart transplantation. RESULTS: In a multivariate analysis, the predictors of all-cause death were left atrial diameter [Hazard ratio (HR): 1.056, 95% confidence interval (CI): 1.020-1.093, P = 0.002]; non-left bundle branch block [HR: 1.793, 95% CI: 1.131-2.844, P = 0.013]; high sensitivity C-reactive protein [HR: 1.081, 95% CI: 1.029-1.134 P = 0.002]; and N-terminal pro-B-type natriuretic peptide [HR: 1.018, 95% CI: 1.007-1.030, P = 0.002]; and New York Heart Association class IV [HR: 1.018, 95% CI: 1.007-1.030, P = 0.002]. The Alpha-score (Atrial diameter, non-LBBB, Pro-BNP, Hs-CRP, NYHA class IV) was derived from each independent risk factor. The novel score had good calibration (Hosmer-Lemeshow test, P > 0.05) and discrimination for both primary endpoints [c-statistics: 0.749 (95% CI: 0.694-0.804), P < 0.001] or heart failure hospitalization [c-statistics: 0.692 (95% CI: 0.639-0.745), P < 0.001]. CONCLUSION: The Alpha-score may enable improved discrimination and accurate prediction of long-term outcomes among NICM patients with CRT.
No takes yet. Share an insight, caveat, or question.
Yang et al. (2020) conducted a cohort in Non-ischemic cardiomyopathy and heart failure (n=422). Alpha-score (Atrial diameter, non-LBBB, Pro-BNP, Hs-CRP, NYHA class IV) vs. Lower Alpha-score was evaluated on All-cause mortality and heart transplantation (c-statistic 0.749, 95% CI 0.694-0.804, p=<0.001). The novel Alpha-score demonstrated good discrimination for predicting all-cause mortality and heart transplantation in non-ischemic cardiomyopathy patients with CRT, with a c-statistic of 0.749.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: