DOI: 10.1161/circ.148.suppl_1.13800 ISSN: 0009-7322

Abstract 13800: Comparison of Predictive Value of Risk Scores for Mortality in Asian Patients With Heart Failure With Preserved Ejection Fraction

Katsuomi Iwakura, Masato Okada, Nobuaki Tanaka, Yasushi Koyama, ATSUNORI OKAMURA, Watanabe Heitaro, Masahiro Seo, Takaharu Hayashi, Masamichi Yano, Akito Nakagawa, Shunsuke Tamaki, Takahisa Yamada, Yasumura Yoshio, Yohei Sotomi, Shungo Hikoso, Daisaku D Nakatani, Yasushi Sakata,
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Background: Several risk scores have been developed to predict mortality and morbidity in heart failure (HF), including heart failure with preserved ejection fraction (HFpEF). However, these scores have primarily been derived from data obtained from Western patients.

Research Questions: It remains unclear whether these risk factors are applicable to Asian patients, whose pathophysiology of HFpEF may exhibit ethnic differences compared to Western populations.

Aims: To compare the predictive value of widely used risk scores for mortality in Japanese patients with HFpEF.

Methods: We assessed the predictive value of three commonly utilized risk scores: MAGGIC, BCN-BioHF, and 3C-HF risk scores, which are applicable to patients with HFpEF. A total of 1,095 patients registered in the PURSUIT-HFpEF, a multicenter registry comprising individuals hospitalized with decompensated HFpEF, were enrolled (mean age 81±9 years, 54.8% female). The MAGGIC risk score and the predicted 1-year mortality rate by the web-based BCN-BioHF and 3C-HF risk calculators were obtained for all patients. Patients were followed for a median duration of 428 days (interquartile range: 208-794 days) to observe all-cause mortality. The predictive value of the risk scores was compared using the area under the curve (AUC) of time-dependent ROC curves for 1-year mortality.

Results: Complete risk scores and predicted 1-year mortality rates were available for 1,082 (98.8%) patients. The AUC for 1-year mortality prediction was 0.73 (95% CI 0.68, 0.78) for the MAGGIC score, 0.65 (0.59, 0.71) for BCN-BioHF, and 0.71 (0.64, 0.76) for 3C-HF. The MAGGIC score exhibited a significantly higher AUC than BCN-BioHF (p=0.003), while no significant differences were observed between the MAGGIC score and 3C-HF, or between BCN-BioHF and 3C-HF.

Conclusion: This study demonstrates that the MAGGIC, BCN-BioHF, and 3C-HF risk scores provide good predictive value for 1-year mortality in Japanese patients with HFpEF. The superior performance of the MAGGIC score suggests that considering the ethnic differences in HFpEF pathophysiology is crucial for accurate risk prediction in Asian populations.

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