PMID- 25903349
OWN - NLM
STAT- MEDLINE
DCOM- 20160524
LR  - 20191210
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Linking)
VI  - 17
IP  - 7
DP  - 2015 Jul
TI  - Validation of a simple risk stratification tool for patients implanted with 
      Cardiac Resynchronization Therapy: the VALID-CRT risk score.
PG  - 717-24
LID - 10.1002/ejhf.269 [doi]
AB  - AIMS: Mortality after cardiac resynchronization therapy (CRT) is difficult to 
      predict. We sought to design and validate a simple prognostic score for patients 
      implanted with CRT, based on readily available clinical variables, including age, 
      gender, left ventricular ejection fraction (LVEF), New York Heart Association 
      (NYHA) class, presence/absence of atrial fibrillation, presence/absence of 
      atrioventricular junction ablation, coronary heart disease, diabetes, and 
      implantation of a CRT device with defibrillation. METHODS: For predictive 
      modelling, 5153 consecutive patients enrolled in 72 European centres (79% male; 
      LVEF 25.9 +/- 6.85%; NYHA class III-IV 77.5%; QRS 158.4 +/- 32.3 ms) were randomly 
      split into derivation (70%) and validation (30%) samples. The primary endpoint 
      was total mortality and the secondary endpoint was cardiovascular mortality. The 
      final predictive model fit was assessed by plotting observed vs. predicted 
      survival. RESULTS: In the entire cohort, 1004 deaths occurred over a follow-up of 
      14 409 person years. Total mortality ranged from 3.1% to 28.2% at 2 years in the 
      first and fifth quintile of the risk score, respectively. At 5 years, total 
      mortality was 10.3%, 18.6%, 27.6%, 36.1%, and 58.8%, from the first to the fifth 
      quintile. Compared with the lowest quintile (Q), total mortality was 
      significantly higher in the other four quintiles [Q2 hazard ratio (HR) = 1.71; Q3 
      HR = 2.20; Q4 HR = 4.03; Q5 HR = 8.03; all P < 0.001). The final model, which was 
      based on the entire cohort using the above variables, showed a good 
      discrimination (Harrell's c = 0.70) and high explained variation (0.26). The mean 
      predicted survival fitted well with the observed survival for up to 6 years of 
      follow-up. CONCLUSIONS: The VALID-CRT risk score, which is based on routine, 
      readily available clinical variables, reliably predicted the long-term total and 
      cardiovascular mortality in patients undergoing CRT. While this score cannot be 
      used to predict the benefit of CRT, it may be useful for predicting survival 
      after CRT. This may have useful implications for follow-up.
CI  - (c) 2015 The Authors. European Journal of Heart Failure (c) 2015 European Society of 
      Cardiology.
FAU - Gasparini, Maurizio
AU  - Gasparini M
AD  - Electrophysiology and Pacing Unit, Humanitas Research Hospital IRCCS, Via Manzoni 
      56 Rozzano (Milano), 20089, Italy.
FAU - Klersy, Catherine
AU  - Klersy C
AD  - Biometry and Clinical Epidemiology, Research Department, IRCCS Fondazione 
      Policlinico San Matteo, Pavia, Italy.
FAU - Leclercq, Cristophe
AU  - Leclercq C
AD  - Department of Cardiology, University Hospital Rennes, Rennes, France.
FAU - Lunati, Maurizio
AU  - Lunati M
AD  - Cardiology Department, Niguarda Ca' Granda Hospital, Milano, Italy.
FAU - Landolina, Maurizio
AU  - Landolina M
AD  - Cardiology Department, Fondazione Policlinico S. Matteo IRCCS, Pavia, Italy.
FAU - Auricchio, Angelo
AU  - Auricchio A
AD  - Fondazione Cardiocentro Ticino, Lugano, Switzerland.
FAU - Santini, Massimo
AU  - Santini M
AD  - Department of Cardiology, San Filippo Neri Hospital, Rome, Italy.
FAU - Boriani, Giuseppe
AU  - Boriani G
AD  - Institute of Cardiology, University of Bologna and Azienda Ospedaliera 
      S.Orsola-Malpighi, Bologna, Italy.
FAU - Proclemer, Alessandro
AU  - Proclemer A
AD  - Department of Cardiology, S. Maria della Misericordia Hospital, Udine, Italy.
FAU - Leyva, Francisco
AU  - Leyva F
AD  - Aston University Medical School and Queen Elizabeth Hospital, Birmingham, UK.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Validation Study
DEP - 20150423
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
SB  - IM
MH  - Aged
MH  - Cardiac Resynchronization Therapy/*mortality
MH  - Female
MH  - Heart Failure/*therapy
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Mortality
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Assessment
OTO - NOTNLM
OT  - Cardiac resynchronization therapy
OT  - Heart failure
OT  - Prognostic index
OT  - Risk-stratification
EDAT- 2015/04/24 06:00
MHDA- 2016/05/25 06:00
CRDT- 2015/04/24 06:00
PHST- 2015/02/23 00:00 [received]
PHST- 2015/03/06 00:00 [revised]
PHST- 2015/03/10 00:00 [accepted]
PHST- 2015/04/24 06:00 [entrez]
PHST- 2015/04/24 06:00 [pubmed]
PHST- 2016/05/25 06:00 [medline]
AID - 10.1002/ejhf.269 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2015 Jul;17(7):717-24. doi: 10.1002/ejhf.269. Epub 2015 Apr 23.