Lewis et al reported the VALIANT Heart Failure Risk Score to evaluate a patient who has had an acute myocardial infarction. This can help to identify a patient who may subsequently develop heart failure. The authors are from multiple institutions from around the world.
Patient selection: stable survivor of a myocardial infraction (no major non-fatal cardiovascular event or death within 45 days)
Parameters:
(1) age in years
(2) race
(3) diabetes
(4) history of a prior myocardial infarction
(5) peripheral vascular disease
(6) new left bundle branch block (LBBB)
(7) Killip class
(8) NYHA class at 45 days
Parameter
Finding
Points
age
<= 50 years
0
51 to 60 years
4
61 to 70 years
5
71 to 80 years
9
> 80 years
10
race
Caucasian
0
Asian
0
African-American
6
other
4
diabetes
no
0
yes
5
prior myocardial infarction
no
0
yes
5
peripheral vascular disease
no
0
yes
5
new left bundle branch block
no
0
yes
5
Killip class
1 or 2
0
3 or 4
3
NYHA
I
0
II
3
III
5
IV
9
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 48
• The higher the score the greater the risk of heart failure.
Total Score
3-Year Heart Failure Rate
0 to 5
2.3%
6 to 8
5.1%
9 to 11
8%
12 to 14
12.2%
15 to 17
18.4%
18 to 20
24.7%
21 to 23
29.8%
24 to 33
33.3%
Performance:
• The area under the ROC curve is 0.73.
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