The MECKI score was significantly superior to the SHFM and HFSS for predicting cardiovascular death, urgent transplantation, or VAD implantation at 2 years (AUC 0.781 vs 0.739 and 0.723).
Cohort (n=6,112)
Yes
Does the MECKI score improve prognostic accuracy compared to HFSS and SHFM in patients with chronic heart failure with reduced ejection fraction?
The MECKI score provides superior long-term prognostic accuracy compared to HFSS and SHFM in stable HFrEF patients.
Effect estimate: AUC 0.781
AIMS: Risk stratification in heart failure (HF) is crucial for clinical and therapeutic management. A multiparametric approach is the best method to stratify prognosis. In 2012, the Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score was proposed to assess the risk of cardiovascular mortality and urgent heart transplantation. The aim of the present study was to compare the prognostic accuracy of MECKI score to that of HF Survival Score (HFSS) and Seattle HF Model (SHFM) in a large, multicentre cohort of HF patients with reduced ejection fraction. METHODS AND RESULTS: We collected data on 6112 HF patients and compared the prognostic accuracy of MECKI score, HFSS, and SHFM at 2- and 4-year follow-up for the combined endpoint of cardiovascular death, urgent cardiac transplantation, or ventricular assist device implantation. Patients were followed up for a median of 3.67 years, and 931 cardiovascular deaths, 160 urgent heart transplantations, and 12 ventricular assist device implantations were recorded. At 2-year follow-up, the prognostic accuracy of MECKI score was significantly superior area under the curve (AUC) 0.781 to that of SHFM (AUC 0.739) and HFSS (AUC 0.723), and this relationship was also confirmed at 4 years (AUC 0.764, 0.725, and 0.720, respectively). CONCLUSION: In this cohort, the prognostic accuracy of the MECKI score was superior to that of HFSS and SHFM at 2- and 4-year follow-up in HF patients in stable clinical condition. The MECKI score may be useful to improve resource allocation and patient outcome, but prospective evaluation is needed.
Agostoni et al. (Tue,) conducted a cohort in Chronic heart failure with reduced ejection fraction (n=6,112). MECKI score vs. HF Survival Score (HFSS) and Seattle HF Model (SHFM) was evaluated on Combined endpoint of cardiovascular death, urgent cardiac transplantation, or ventricular assist device implantation (AUC 0.781). The MECKI score was significantly superior to the SHFM and HFSS for predicting cardiovascular death, urgent transplantation, or VAD implantation at 2 years (AUC 0.781 vs 0.739 and 0.723).