Heart failure survival score continues to predict clinical outcomes in patients with heart failure receiving β-blockers
The Heart Failure Survival Score (HFSS) has been previously shown to effectively risk-stratify patients under evaluation for heart transplantation. However, this model was developed before broad use of beta blockade. We hypothesized that the prognostic tool would retain its ability to risk stratify...
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| Veröffentlicht in: | The Journal of heart and lung transplantation 2004-12, Vol.23 (12), p.1414-1422 |
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| container_title | The Journal of heart and lung transplantation |
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| creator | Koelling, Todd M. Joseph, Susan Aaronson, Keith D. |
| description | The Heart Failure Survival Score (HFSS) has been previously shown to effectively risk-stratify patients under evaluation for heart transplantation. However, this model was developed before broad use of beta blockade. We hypothesized that the prognostic tool would retain its ability to risk stratify patients treated with β-blockers.
We collected clinical data on 524 consecutive patients referred for heart transplantation from 1994 to 2001. Kaplan-Meier survival analysis and multivariable Cox regression analysis were performed with events defined as death, left ventricular assist device placement, or United Network of Organ Sharing 1 heart transplantation.
Kaplan-Meier analysis of the patient population revealed effective discrimination by the survival score both for β-blocker treated and untreated patients (both
p < 0.0001). Two-year event-free survival was 94% ± 2% and 84% ± 4% for β-blocker and no β-blocker patients in the low-risk HFSS strata. Cox proportional hazard modeling showed that HFSS strata (medium risk: HR 2.65, 95% CI 1.75–4.02,
p < 0.001; high risk: HR 5.51, 95% CI 3.64–8.33,
p < 0.001) and β-blocker treatment (HR 0.45, 95% CI 0.31–0.64,
p < 0.001) were significant predictors of event-free survival. Receiver operating curves (area under the curve) for HFSS strata used to predict 2-year events were similar for β-blocker treated (0.78 ± 0.04) and untreated (0.80 ± 0.03) patients.
The HFSS provides effective risk stratification with or without β-blocker therapy. Consideration of β-blocker therapy with survival score strata improves outcome prediction in patients evaluated for heart transplantation. |
| doi_str_mv | 10.1016/j.healun.2003.10.002 |
| format | Article |
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We collected clinical data on 524 consecutive patients referred for heart transplantation from 1994 to 2001. Kaplan-Meier survival analysis and multivariable Cox regression analysis were performed with events defined as death, left ventricular assist device placement, or United Network of Organ Sharing 1 heart transplantation.
Kaplan-Meier analysis of the patient population revealed effective discrimination by the survival score both for β-blocker treated and untreated patients (both
p < 0.0001). Two-year event-free survival was 94% ± 2% and 84% ± 4% for β-blocker and no β-blocker patients in the low-risk HFSS strata. Cox proportional hazard modeling showed that HFSS strata (medium risk: HR 2.65, 95% CI 1.75–4.02,
p < 0.001; high risk: HR 5.51, 95% CI 3.64–8.33,
p < 0.001) and β-blocker treatment (HR 0.45, 95% CI 0.31–0.64,
p < 0.001) were significant predictors of event-free survival. Receiver operating curves (area under the curve) for HFSS strata used to predict 2-year events were similar for β-blocker treated (0.78 ± 0.04) and untreated (0.80 ± 0.03) patients.
The HFSS provides effective risk stratification with or without β-blocker therapy. Consideration of β-blocker therapy with survival score strata improves outcome prediction in patients evaluated for heart transplantation.</description><identifier>ISSN: 1053-2498</identifier><identifier>EISSN: 1557-3117</identifier><identifier>DOI: 10.1016/j.healun.2003.10.002</identifier><identifier>PMID: 15607672</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adrenergic beta-Antagonists - therapeutic use ; Adult ; Aged ; Biological and medical sciences ; Cardiology. Vascular system ; Disease-Free Survival ; Exercise Test ; Female ; Heart ; Heart Failure - drug therapy ; Heart Failure - mortality ; Heart Failure - physiopathology ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Humans ; Male ; Medical sciences ; Middle Aged ; Oxygen Consumption ; Proportional Hazards Models ; Risk ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Survival Rate</subject><ispartof>The Journal of heart and lung transplantation, 2004-12, Vol.23 (12), p.1414-1422</ispartof><rights>2004 International Society for Heart and Lung Transplantation</rights><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-980f9e00345e954e92e3c95f12d3ec262ee93ec1e294e4233572c7ac96a3c943</citedby><cites>FETCH-LOGICAL-c390t-980f9e00345e954e92e3c95f12d3ec262ee93ec1e294e4233572c7ac96a3c943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.healun.2003.10.002$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16390652$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15607672$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koelling, Todd M.</creatorcontrib><creatorcontrib>Joseph, Susan</creatorcontrib><creatorcontrib>Aaronson, Keith D.</creatorcontrib><title>Heart failure survival score continues to predict clinical outcomes in patients with heart failure receiving β-blockers</title><title>The Journal of heart and lung transplantation</title><addtitle>J Heart Lung Transplant</addtitle><description>The Heart Failure Survival Score (HFSS) has been previously shown to effectively risk-stratify patients under evaluation for heart transplantation. However, this model was developed before broad use of beta blockade. We hypothesized that the prognostic tool would retain its ability to risk stratify patients treated with β-blockers.
We collected clinical data on 524 consecutive patients referred for heart transplantation from 1994 to 2001. Kaplan-Meier survival analysis and multivariable Cox regression analysis were performed with events defined as death, left ventricular assist device placement, or United Network of Organ Sharing 1 heart transplantation.
Kaplan-Meier analysis of the patient population revealed effective discrimination by the survival score both for β-blocker treated and untreated patients (both
p < 0.0001). Two-year event-free survival was 94% ± 2% and 84% ± 4% for β-blocker and no β-blocker patients in the low-risk HFSS strata. Cox proportional hazard modeling showed that HFSS strata (medium risk: HR 2.65, 95% CI 1.75–4.02,
p < 0.001; high risk: HR 5.51, 95% CI 3.64–8.33,
p < 0.001) and β-blocker treatment (HR 0.45, 95% CI 0.31–0.64,
p < 0.001) were significant predictors of event-free survival. Receiver operating curves (area under the curve) for HFSS strata used to predict 2-year events were similar for β-blocker treated (0.78 ± 0.04) and untreated (0.80 ± 0.03) patients.
The HFSS provides effective risk stratification with or without β-blocker therapy. Consideration of β-blocker therapy with survival score strata improves outcome prediction in patients evaluated for heart transplantation.</description><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Disease-Free Survival</subject><subject>Exercise Test</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Failure - drug therapy</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - physiopathology</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Oxygen Consumption</subject><subject>Proportional Hazards Models</subject><subject>Risk</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Survival Rate</subject><issn>1053-2498</issn><issn>1557-3117</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM9uEzEQhy1ERduUN0DIF7ht8J_1bnxBQhVQpEq99G65k1nisLGD7Q3wWjxIn4lZJVLVCyePx59H8_sYeyPFUgrZfdguN-jHKS6VEJpaSyHUC3YhjekbLWX_kmphdKNauzpnl6VsBRHaqFfsXJpO9F2vLtjvG_S58sGHccrIy5QP4eBHXiDRFVKsIU5YeE18n3EdoHIYQwxATJoqpB09hsj3vgaMtfBfoW745tnQjIDhEOJ3_vi3eRgT_MBcrtjZ4MeCr0_ngt1_-Xx_fdPc3n39dv3ptgFtRW3sSgwWKWFr0JoWrUIN1gxSrTWC6hSipUKisi22SmvTK-g92M4T1-oFe38cu8_pJwWpbhcK4Dj6iGkqruvlqtUrS2B7BCGnUjIObp_Dzuc_Tgo3C3dbdxTuZuFzd9a5YG9P86eHHa6fPp0ME_DuBPhC0obsI4TyxHUUszMz9_HIIck4BMyuABkFck7-qlun8P9N_gGCaaM1</recordid><startdate>20041201</startdate><enddate>20041201</enddate><creator>Koelling, Todd M.</creator><creator>Joseph, Susan</creator><creator>Aaronson, Keith D.</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20041201</creationdate><title>Heart failure survival score continues to predict clinical outcomes in patients with heart failure receiving β-blockers</title><author>Koelling, Todd M. ; Joseph, Susan ; Aaronson, Keith D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-980f9e00345e954e92e3c95f12d3ec262ee93ec1e294e4233572c7ac96a3c943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adrenergic beta-Antagonists - therapeutic use</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Disease-Free Survival</topic><topic>Exercise Test</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Failure - drug therapy</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - physiopathology</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Oxygen Consumption</topic><topic>Proportional Hazards Models</topic><topic>Risk</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koelling, Todd M.</creatorcontrib><creatorcontrib>Joseph, Susan</creatorcontrib><creatorcontrib>Aaronson, Keith D.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of heart and lung transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koelling, Todd M.</au><au>Joseph, Susan</au><au>Aaronson, Keith D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Heart failure survival score continues to predict clinical outcomes in patients with heart failure receiving β-blockers</atitle><jtitle>The Journal of heart and lung transplantation</jtitle><addtitle>J Heart Lung Transplant</addtitle><date>2004-12-01</date><risdate>2004</risdate><volume>23</volume><issue>12</issue><spage>1414</spage><epage>1422</epage><pages>1414-1422</pages><issn>1053-2498</issn><eissn>1557-3117</eissn><abstract>The Heart Failure Survival Score (HFSS) has been previously shown to effectively risk-stratify patients under evaluation for heart transplantation. However, this model was developed before broad use of beta blockade. We hypothesized that the prognostic tool would retain its ability to risk stratify patients treated with β-blockers.
We collected clinical data on 524 consecutive patients referred for heart transplantation from 1994 to 2001. Kaplan-Meier survival analysis and multivariable Cox regression analysis were performed with events defined as death, left ventricular assist device placement, or United Network of Organ Sharing 1 heart transplantation.
Kaplan-Meier analysis of the patient population revealed effective discrimination by the survival score both for β-blocker treated and untreated patients (both
p < 0.0001). Two-year event-free survival was 94% ± 2% and 84% ± 4% for β-blocker and no β-blocker patients in the low-risk HFSS strata. Cox proportional hazard modeling showed that HFSS strata (medium risk: HR 2.65, 95% CI 1.75–4.02,
p < 0.001; high risk: HR 5.51, 95% CI 3.64–8.33,
p < 0.001) and β-blocker treatment (HR 0.45, 95% CI 0.31–0.64,
p < 0.001) were significant predictors of event-free survival. Receiver operating curves (area under the curve) for HFSS strata used to predict 2-year events were similar for β-blocker treated (0.78 ± 0.04) and untreated (0.80 ± 0.03) patients.
The HFSS provides effective risk stratification with or without β-blocker therapy. Consideration of β-blocker therapy with survival score strata improves outcome prediction in patients evaluated for heart transplantation.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15607672</pmid><doi>10.1016/j.healun.2003.10.002</doi><tpages>9</tpages></addata></record> |
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| subjects | Adrenergic beta-Antagonists - therapeutic use Adult Aged Biological and medical sciences Cardiology. Vascular system Disease-Free Survival Exercise Test Female Heart Heart Failure - drug therapy Heart Failure - mortality Heart Failure - physiopathology Heart failure, cardiogenic pulmonary edema, cardiac enlargement Humans Male Medical sciences Middle Aged Oxygen Consumption Proportional Hazards Models Risk Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Survival Rate |
| title | Heart failure survival score continues to predict clinical outcomes in patients with heart failure receiving β-blockers |
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