The GWTG-HF risk score significantly predicted all-cause mortality (HR 1.537; 95% CI 1.172-2.023 per 10-point increase) and cardiac events in patients with heart failure after discharge.
Cohort (n=1,452)
No
Does the GWTG-HF risk score predict long-term all-cause mortality and cardiac events in patients with heart failure after discharge?
The GWTG-HF risk score, originally developed to predict in-hospital mortality, is also a significant predictor of long-term all-cause mortality and cardiac events in discharged heart failure patients.
Effect estimate: HR 1.537 (95% CI 1.172-2.023)
Background The Get With the Guidelines-Heart Failure ( GWTG - HF ) risk score was developed using American Heart Association GWTG - HF program data and predicts in-hospital mortality in patients with acute heart failure (HF). We aimed to clarify the prognostic impacts of the GWTG - HF risk score in patients with HF after discharge. Methods and Results We examined the GWTG - HF score in 1452 patients with HF, who were admitted to our hospital and discharged after treatment, by calculating 7 predetermined variables. We divided all subjects into 3 groups according to the GWTG - HF risk score (low, moderate, and high score groups). The plasma B-type natriuretic peptide level significantly increased with increasing GWTG - HF risk score severity (median values of B-type natriuretic peptide: 167.0 in low, 260.7 in moderate, and 418.2 pg/mL in high score groups). We followed up all subjects after discharge, and there were 347 (23.9%) all-cause deaths and 407 (28.0%) cardiac events in follow-up periods. A Kaplan-Meier survival curve demonstrated that event rates of all-cause death and cardiovascular events, including worsening HF and cardiac death, significantly increased with increasing GWTG - HF risk score severity in all subjects, and also in 749 patients with HF with preserved ejection fraction (ejection fraction ≥50%) and 703 patients with HF with reduced ejection fraction (ejection fraction <50%) patients. The multivariable Cox proportional hazard regression analysis demonstrated that the GWTG - HF risk score was one of the significant predictors of all-cause mortality and cardiac events (all-cause mortality: hazard ratio, 1.537, 95% confidence interval, 1.172-2.023; cardiac events: hazard ratio, 1.584, 95% confidence interval, 1.344-1.860, per 10-point increase of GWTG - HF score). Conclusions The GWTG - HF risk score is a useful multivariable score model for several years after hospitalization in patients with HF in a Japanese population.
Suzuki et al. (2018) conducted a cohort in Chronic Heart Failure (n=1,452). Get With the Guidelines-Heart Failure (GWTG-HF) risk score vs. Low vs moderate vs high score groups was evaluated on All-cause mortality (HR 1.537, 95% CI 1.172-2.023). The GWTG-HF risk score significantly predicted all-cause mortality (HR 1.537; 95% CI 1.172-2.023 per 10-point increase) and cardiac events in patients with heart failure after discharge.