Simple Risk Score to Predict Survival in Acute Decompensated Heart Failure : A₂B Score

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  • Nakada Yasuki
    Department of Cardiovascular Medicine, Nara Medical University
  • Kawakami Rika
    Department of Cardiovascular Medicine, Nara Medical University
  • Matsushima Shouji
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
  • Ide Tomomi
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
  • Kanaoka Koshiro
    Department of Cardiovascular Medicine, Nara Medical University
  • Ueda Tomoya
    Department of Cardiovascular Medicine, Nara Medical University
  • Ishihara Satomi
    Department of Cardiovascular Medicine, Nara Medical University
  • Nishida Taku
    Department of Cardiovascular Medicine, Nara Medical University
  • Onoue Kenji
    Department of Cardiovascular Medicine, Nara Medical University
  • Soeda Tsunenari
    Department of Cardiovascular Medicine, Nara Medical University
  • Okayama Satoshi
    Department of Cardiovascular Medicine, Nara Medical University
  • Watanabe Makoto
    Department of Cardiovascular Medicine, Nara Medical University
  • Okura Hiroyuki
    Department of Cardiovascular Medicine, Nara Medical University
  • Tsuchihashi-Makaya Miyuki
    School of Nursing, Kitasato University
  • Tsutsui Hiroyuki
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
  • Saito Yoshihiko
    Department of Cardiovascular Medicine, Nara Medical University

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タイトル別名
  • Simple Risk Score to Predict Survival in Acute Decompensated Heart Failure　― A<sub>2</sub>B Score ―

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抄録

<p>Background: Prognosis after acute decompensated heart failure (ADHF) is poor. An appropriate risk score that would allow for improved care and treatment of ADHF patients after discharge, however, is lacking. </p><p>Methods and Results: We used 2 HF cohorts, the NARA-HF study and JCARE-CARD, as derivation and validation cohorts, respectively. The primary endpoint was all-cause death during the 2-year follow-up, excluding in-hospital death. Age, hemoglobin (Hb), and brain natriuretic peptide (BNP) at discharge were identified as independent risk factors. We determined 3 categorizations on the basis of these parameters, termed A2B score: age (<65 years, 0; 65–74 years, 1; ≥75 years, 2), anemia (Hb <10 g/dL, 2; 10–11.9 g/dL, 1; ≥12 g/dL, 0) and BNP (<200 pg/mL, 0; 200–499 pg/mL, 1; ≥500 pg/mL, 2). We divided patients into 4 groups according to A2B score (extremely low, 0; low, 1–2; medium, 3–4; high, 5–6). For the extremely low-risk group, the 2-year survival rate was 97.8%, compared with 84.5%, 66.1%, and 45.2% for the low-, medium-, and high-risk groups, respectively. Using the JCARE-CARD as a validation model, for the extremely low-risk group, the 2-year survival was 95.4%, compared with 90.2%, 75.0%, and 55.6% for the low-, medium-, and high-risk groups, respectively. </p><p>Conclusions: The user-friendly A2B score is useful for estimating survival rate in ADHF patients at discharge. </p>

収録刊行物

  • Circulation Journal

    Circulation Journal 83 (5), 1019-1024, 2019-04-25

    一般社団法人 日本循環器学会

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