Usefulness of Age, Creatinine and Ejection Fraction - Modification of
Diet in Renal Disease Score for Predicting Survival in Patients with
Heart Failure
Abstract
Background: While many risk models have been developed to predict
prognosis in heart failure (HF), these models are rarely useful for the
clinical practitioner as they include multiple variables that might be
time-consuming to obtain, they are usually difficult to calculate and
they may suffer from statistical overfitting. Present study aimed to
investigate whether a simpler model, namely ACEF-MDRD score, could be
used for predicting one-year mortality in HF patients. Methods: 748
cases within the SELFIE-HF registry had complete data to calculate
ACEF-MDRD score. Patients were grouped into tertiles for analyses.
Results: Significantly more patients within the ACEF-MDRDhigh tertile
(30.0%) died within one year, as compared to other tertiles (10.8% and
16.1%, respectively, for ACEF-MDRDlow and ACEF-MDRDmed,
p<0.001 for both comparisons). There was a stepwise decrease
in one-year survival as ACEF-MDRD score increased (log-rank
p<0.001). ACEF-MDRD was an independent predictor of survival
after adjusting for other variables (OR: 1.14, 95%CI:1.04 – 1.24,
p=0.006). ACEF-MDRD score offered similar accuracy to GWTG-HF score for
prediction of one-year mortality (p=0.14). Conclusions: ACEF-MDRD is a
predictor of mortality in patients with HF, and its usefulness is
comparable to similar yet more complicated models.