Ibrahim et al reported a score for predicting new-onset heart failure in a patient undergoing angiography. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in the United States and The Netherlands involved in the CASABLANCA study.
Patient selection: coronary or peripheral angiography
Outcome: new-onset heart failure
Parameters:
(1) age in years
(2) sex
(3) heart rate in beats per minute
(4) history of atrial fibrillation
(5) history of hypertension
(6) serum NT-proBNP in pg/mL
(7) ST2 in ng/mL (belongs to the interleukin-1 receptor family; it is released under conditions of cardiovascular stress)
|
Parameter |
Finding |
Points |
|
age in years |
20 to 29 years of age |
-4 |
|
|
30 to 39 |
-3 |
|
|
40 to 49 |
-2 |
|
|
50 to 59 |
-1 |
|
|
60 to 69 |
0 |
|
|
70 to 79 |
1 |
|
|
80 to 89 |
2 |
|
|
90 to 99 |
3 |
|
sex |
male |
1 |
|
|
female |
0 |
|
heart rate |
30 to 39 beats per minute |
-3 |
|
|
40 to 49 |
-2 |
|
|
50 to 59 |
-1 |
|
|
60 to 79 |
0 |
|
|
80 to 89 |
1 |
|
|
90 to 99 |
2 |
|
|
100 to 109 |
3 |
|
|
110 to 129 |
4 |
|
history of atrial fibrillation |
no |
0 |
|
|
yes |
3 |
|
history of hypertension |
no |
0 |
|
|
yes |
4 |
|
NT-proBPN |
< 1,000 pg/mL |
0 |
|
|
>= 1,000 pg/mL |
6 |
|
ST2 |
< 35 ng/mL |
0 |
|
|
>= 35 ng/mL |
3 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -7
• maximum score: 24
• The higher the score the greater the risk of heart failure.
|
Total Score |
Risk CHF |
|
-4 to -7 |
< 1% |
|
-3 to 0 |
1-2% |
|
1 |
2.2% |
|
2 |
2.6% |
|
3 |
3.1% |
|
4 |
3.6% |
|
5 |
4.2% |
|
6 |
5% |
|
7 |
6% |
|
8 |
7% |
|
9 |
8% |
|
10 |
9% |
|
11 |
11% |
|
12 |
13% |
|
13 |
15% |
|
14 |
17% |
|
15 |
20% |
|
16 |
23% |
|
17 |
27% |
|
18 |
30% |
|
19 |
35% |
|
20 |
40% |
|
21 |
45% |
|
22 |
50% |
|
23 |
56% |
|
24 |
62% |
Performance:
• The area under the ROC curve is 0.76.
Specialty: Cardiology
