Lewis et al identified predictors for heart failure in a patient with stable coronary artery disease. They developed a score to identify patients who may be at greater risk. The authors are from multiple institutions in North America and Europe.
Patient selection: stable coronary artery disease with LVEF > 40%
Parameters:
(1) age in years
(2) body mass index (BMI)
(3) history of myocardial infarction
(4) history of CABG surgery
(5) history of diabetes
(6) history of hypertension
(7) history of angina
(8) history of stroke or transient ischemic attack (TIA)
(9) current smoker
(10) eGFR in mL per min per 1.73 square meter
(11) left ventricular ejection fraction (LVEF) in percent
(12) therapy with calcium channel blocker
(13) therapy with lipid lowering medication
(14) therapy with any diuretic
(15) therapy with digitalis
(16) therapy with anti-arrhythmic medication
(17) therapy with trandolapril
|
Parameter |
Finding |
Points |
|
age in years |
< 65 years |
0 |
|
|
65 to 74 years |
2 |
|
|
>= 75 years |
4 |
|
BMI |
< 35 |
0 |
|
|
>= 35 |
2 |
|
history of MI |
no |
0 |
|
|
yes |
1 |
|
history of CABG surgery |
no |
0 |
|
|
yes |
1 |
|
history of diabetes |
no |
0 |
|
|
yes |
2 |
|
history of hypertension |
no |
0 |
|
|
yes |
2 |
|
history of angina |
no |
0 |
|
|
yes |
1 |
|
history of stroke or TIA |
no |
0 |
|
|
yes |
2 |
|
current smoker |
no |
0 |
|
|
yes |
2 |
|
eGFR |
>= 60 |
0 |
|
|
< 60 |
2 |
|
LVEF |
>= 50% |
0 |
|
|
41 to 50% |
1 |
|
|
< 41% |
NA |
|
calcium channel blocker |
no |
0 |
|
|
yes |
1 |
|
lipid lowering agent |
no |
2 |
|
|
yes |
0 |
|
diuretic |
no |
0 |
|
|
yes |
2 |
|
digitalis use |
no |
0 |
|
|
yes |
3 |
|
anti-arrhythmic drug |
no |
0 |
|
|
yes |
3 |
|
trandolapril |
no |
1 |
|
|
yes |
0 |
total score =
= SUM(points for all parameters)
Interpretation:
• minimum score: 0
• maximum score: 32
• The higher the score the greater the risk of heart failure.
|
Total Score |
Risk Group |
|
0 to 8 |
low |
|
9 to 14 |
intermediate |
|
>= 15 |
high |
Performance:
• The area under the ROC curve is 0.80.
Specialty: Cardiology
