The H2FPEF score independently predicted composite cardiovascular and cerebrovascular events in HFpEF patients (HR 1.179 per 1-point increase; 95% CI 1.066-1.305; P=0.001).
Observational (n=404)
No
Does the H2FPEF score predict cardiovascular and heart failure-related events in patients with HFpEF?
The H2FPEF score, originally designed for diagnosis, is also an independent predictor of long-term cardiovascular and heart failure events in patients with HFpEF.
Effect estimate: HR 1.179 (95% CI 1.066-1.305)
p-value: p=0.001
BACKGROUND: The H2FPEF score is recognized as a simple method to diagnose heart failure (HF) with preserved left ventricular ejection fraction (HFpEF). We investigated the value of the H2FPEF score in predicting subsequent cardiovascular events in HFpEF patients. METHODS: This study was a retrospective, single-center, observational study. We calculated the H2FPEF scores for 404 consecutive HFpEF patients. Subjects were subdivided into low- (0-3), intermediate- (4-6), and high-score (7-9) groups and followed for 50 months. The primary and secondary endpoints were composite cardiovascular/cerebrovascular events (cardiovascular death, nonfatal myocardial infarction, unstable angina pectoris, hospitalization for HF decompensation, and nonfatal stroke) occurrence and HF-related events (hospitalization for HF decompensation) occurrence at 50 months, respectively. RESULTS: Kaplan-Meier analyses demonstrated a significantly higher incidence of cardiovascular/cerebrovascular events among those with a higher H2FPEF score (log-rank test, P = 0.005). The HF-related event rate was higher in proportion to the H2FPEF score (log-rank test, P < 0.001). Multivariate Cox hazard analyses identified the H2FPEF score (per 1 point) as an independent predictor of cardiovascular and HF-related events (hazard ratio HR, 1.179; 95% confidence interval CI, 1.066-1.305; P = 0.001 and HR, 1.288; 95% CI, 1.134-1.463; P = 0.001, respectively). Receiver operating characteristic analysis showed that the H2FPEF significantly predicted cardiovascular events (area under the curve AUC, 0.626; 95% CI, 0.557-0.693; P < 0.001) and HF-related events (AUC, 0.680; 95% CI, 0.600-0.759; P < 0.001). The cutoff H2FPEF score was 5.5 for the identification of cardiovascular and HF-related events. CONCLUSION: The H2FPEF score might be a potentially useful marker for the prediction of cardiovascular and HF-related events in HFpEF patients. CLINICAL TRAILS REGISTRATION: Trail Number UMIN000029600.
Sueta et al. (Wed,) conducted a observational in Heart failure with preserved left ventricular ejection fraction (HFpEF) (n=404). H2FPEF score vs. Low (0-3), intermediate (4-6), and high (7-9) score groups was evaluated on Composite cardiovascular/cerebrovascular events (cardiovascular death, nonfatal myocardial infarction, unstable angina pectoris, hospitalization for HF decompensation, and nonfatal stroke) (HR 1.179, 95% CI 1.066-1.305, p=0.001). The H2FPEF score independently predicted composite cardiovascular and cerebrovascular events in HFpEF patients (HR 1.179 per 1-point increase; 95% CI 1.066-1.305; P=0.001).