Performance of AHEAD score in an asian cohort of acute heart failure with either preserved or reduced left ventricular systolic function

Yu Jen Chen, Shih Hsien Sung, Hao Min Cheng, Wei Ming Huang, Chung Li Wu, Chi Jung Huang, Pai Feng Hsu, Jong Shiuan Yeh, Chao Yu Guo, Wen Chung Yu, Chen Huan Chen

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background- AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score has been related to clinical outcomes of acute heart failure. However, the prognostic value of the AHEAD score in acute heart failure patients with either reduced or preserved left ventricular ejection fraction (HFrEF and HFpEF) remain to be elucidated. Methods and Results- The study population consisted of 2143 patients (age 77±12 years, 68% men, 38% HFrEF) hospitalized primarily for acute heart failure with a median follow-up of 23.75 months. The performance of the AHEAD score (atrial fibrillation, hemoglobin < 13 mg/dL for men and 12 mg/dL for women, age > 70 years, creatinine > 130 lmol/L, and diabetes mellitus) was evaluated by Cox's regression analysis for predicting cardiovascular and all-cause mortality. The mean AHEAD scores were 2.7±1.2 in the total study population, 2.6±1.3 in the HFrEF group, and 2.7±1.1 in the HFpEF group. After accounting for sex, sodium, uric acid, and medications, the AHEAD score remained significantly associated with all-cause and cardiovascular mortality (hazard ratio and 95% CI: 1.49, 1.38-1.60 and 1.48, 1.33-1.64), respectively. The associations of AHEAD score with mortality remained significant in the subgroups of HFrEF (1.63, 1.47-1.82) and HFpEF (1.34, 1.22-1.48). Moreover, when we calculated a new AHEAD-U score by considering uric acid (> 8.6 mg/dL) in addition to the AHEAD score, the net reclassification was improved by 19.7% and 20.1% for predicting all-cause and cardiovascular mortality, respectively. Conclusions- The AHEAD score was useful in predicting long-term mortality in the Asian acute heart failure cohort with either HFrEF or HFpEF. The new AHEAD-U score may further improve risk stratification.

Original languageEnglish
Article numbere004297
JournalJournal of the American Heart Association
Volume6
Issue number5
DOIs
Publication statusPublished - May 1 2017

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Left Ventricular Function
Heart Failure
Mortality
Uric Acid
Atrial Fibrillation
Diabetes Mellitus
Hemoglobin H
Stroke Volume
Population
Creatinine
Hemoglobins
Sodium
Regression Analysis
Kidney

Keywords

  • Acute heart failure
  • Ejection fraction
  • Prognosis
  • Uric acid

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Performance of AHEAD score in an asian cohort of acute heart failure with either preserved or reduced left ventricular systolic function. / Chen, Yu Jen; Sung, Shih Hsien; Cheng, Hao Min; Huang, Wei Ming; Wu, Chung Li; Huang, Chi Jung; Hsu, Pai Feng; Yeh, Jong Shiuan; Guo, Chao Yu; Yu, Wen Chung; Chen, Chen Huan.

In: Journal of the American Heart Association, Vol. 6, No. 5, e004297, 01.05.2017.

Research output: Contribution to journalArticle

Chen, Yu Jen ; Sung, Shih Hsien ; Cheng, Hao Min ; Huang, Wei Ming ; Wu, Chung Li ; Huang, Chi Jung ; Hsu, Pai Feng ; Yeh, Jong Shiuan ; Guo, Chao Yu ; Yu, Wen Chung ; Chen, Chen Huan. / Performance of AHEAD score in an asian cohort of acute heart failure with either preserved or reduced left ventricular systolic function. In: Journal of the American Heart Association. 2017 ; Vol. 6, No. 5.
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abstract = "Background- AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score has been related to clinical outcomes of acute heart failure. However, the prognostic value of the AHEAD score in acute heart failure patients with either reduced or preserved left ventricular ejection fraction (HFrEF and HFpEF) remain to be elucidated. Methods and Results- The study population consisted of 2143 patients (age 77±12 years, 68{\%} men, 38{\%} HFrEF) hospitalized primarily for acute heart failure with a median follow-up of 23.75 months. The performance of the AHEAD score (atrial fibrillation, hemoglobin < 13 mg/dL for men and 12 mg/dL for women, age > 70 years, creatinine > 130 lmol/L, and diabetes mellitus) was evaluated by Cox's regression analysis for predicting cardiovascular and all-cause mortality. The mean AHEAD scores were 2.7±1.2 in the total study population, 2.6±1.3 in the HFrEF group, and 2.7±1.1 in the HFpEF group. After accounting for sex, sodium, uric acid, and medications, the AHEAD score remained significantly associated with all-cause and cardiovascular mortality (hazard ratio and 95{\%} CI: 1.49, 1.38-1.60 and 1.48, 1.33-1.64), respectively. The associations of AHEAD score with mortality remained significant in the subgroups of HFrEF (1.63, 1.47-1.82) and HFpEF (1.34, 1.22-1.48). Moreover, when we calculated a new AHEAD-U score by considering uric acid (> 8.6 mg/dL) in addition to the AHEAD score, the net reclassification was improved by 19.7{\%} and 20.1{\%} for predicting all-cause and cardiovascular mortality, respectively. Conclusions- The AHEAD score was useful in predicting long-term mortality in the Asian acute heart failure cohort with either HFrEF or HFpEF. The new AHEAD-U score may further improve risk stratification.",
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author = "Chen, {Yu Jen} and Sung, {Shih Hsien} and Cheng, {Hao Min} and Huang, {Wei Ming} and Wu, {Chung Li} and Huang, {Chi Jung} and Hsu, {Pai Feng} and Yeh, {Jong Shiuan} and Guo, {Chao Yu} and Yu, {Wen Chung} and Chen, {Chen Huan}",
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T1 - Performance of AHEAD score in an asian cohort of acute heart failure with either preserved or reduced left ventricular systolic function

AU - Chen, Yu Jen

AU - Sung, Shih Hsien

AU - Cheng, Hao Min

AU - Huang, Wei Ming

AU - Wu, Chung Li

AU - Huang, Chi Jung

AU - Hsu, Pai Feng

AU - Yeh, Jong Shiuan

AU - Guo, Chao Yu

AU - Yu, Wen Chung

AU - Chen, Chen Huan

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Background- AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score has been related to clinical outcomes of acute heart failure. However, the prognostic value of the AHEAD score in acute heart failure patients with either reduced or preserved left ventricular ejection fraction (HFrEF and HFpEF) remain to be elucidated. Methods and Results- The study population consisted of 2143 patients (age 77±12 years, 68% men, 38% HFrEF) hospitalized primarily for acute heart failure with a median follow-up of 23.75 months. The performance of the AHEAD score (atrial fibrillation, hemoglobin < 13 mg/dL for men and 12 mg/dL for women, age > 70 years, creatinine > 130 lmol/L, and diabetes mellitus) was evaluated by Cox's regression analysis for predicting cardiovascular and all-cause mortality. The mean AHEAD scores were 2.7±1.2 in the total study population, 2.6±1.3 in the HFrEF group, and 2.7±1.1 in the HFpEF group. After accounting for sex, sodium, uric acid, and medications, the AHEAD score remained significantly associated with all-cause and cardiovascular mortality (hazard ratio and 95% CI: 1.49, 1.38-1.60 and 1.48, 1.33-1.64), respectively. The associations of AHEAD score with mortality remained significant in the subgroups of HFrEF (1.63, 1.47-1.82) and HFpEF (1.34, 1.22-1.48). Moreover, when we calculated a new AHEAD-U score by considering uric acid (> 8.6 mg/dL) in addition to the AHEAD score, the net reclassification was improved by 19.7% and 20.1% for predicting all-cause and cardiovascular mortality, respectively. Conclusions- The AHEAD score was useful in predicting long-term mortality in the Asian acute heart failure cohort with either HFrEF or HFpEF. The new AHEAD-U score may further improve risk stratification.

AB - Background- AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score has been related to clinical outcomes of acute heart failure. However, the prognostic value of the AHEAD score in acute heart failure patients with either reduced or preserved left ventricular ejection fraction (HFrEF and HFpEF) remain to be elucidated. Methods and Results- The study population consisted of 2143 patients (age 77±12 years, 68% men, 38% HFrEF) hospitalized primarily for acute heart failure with a median follow-up of 23.75 months. The performance of the AHEAD score (atrial fibrillation, hemoglobin < 13 mg/dL for men and 12 mg/dL for women, age > 70 years, creatinine > 130 lmol/L, and diabetes mellitus) was evaluated by Cox's regression analysis for predicting cardiovascular and all-cause mortality. The mean AHEAD scores were 2.7±1.2 in the total study population, 2.6±1.3 in the HFrEF group, and 2.7±1.1 in the HFpEF group. After accounting for sex, sodium, uric acid, and medications, the AHEAD score remained significantly associated with all-cause and cardiovascular mortality (hazard ratio and 95% CI: 1.49, 1.38-1.60 and 1.48, 1.33-1.64), respectively. The associations of AHEAD score with mortality remained significant in the subgroups of HFrEF (1.63, 1.47-1.82) and HFpEF (1.34, 1.22-1.48). Moreover, when we calculated a new AHEAD-U score by considering uric acid (> 8.6 mg/dL) in addition to the AHEAD score, the net reclassification was improved by 19.7% and 20.1% for predicting all-cause and cardiovascular mortality, respectively. Conclusions- The AHEAD score was useful in predicting long-term mortality in the Asian acute heart failure cohort with either HFrEF or HFpEF. The new AHEAD-U score may further improve risk stratification.

KW - Acute heart failure

KW - Ejection fraction

KW - Prognosis

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