Kyodo Atsushi, Nakada Yasuki, Nogi Maki, Nogi Kazutaka, Ishihara Satomi, Ueda Tomoya, Tohyama Takeshi, Enzan Nobuyuki, Ide Tomomi, Matsushima Shouji, Tsutsui Hiroyuki, Saito Yoshihiko
Department of Cardiovascular Medicine Nara Medical University Kashihara Japan.
Department of Cardiovascular Medicine, Faculty of Medical Sciences Kyushu University Fukuoka Japan.
J Am Heart Assoc. 2024 Feb 20;13(4):e031104. doi: 10.1161/JAHA.123.031104. Epub 2024 Feb 13.
Although a tool for sharing patient prognosis among all medical staff is desirable in heart failure (HF) cases, only a few simple HF prognostic scores are available. We previously presented the AB score, a simple user-friendly HF risk score, and validated it in a small single-center cohort. In the present study, we validated it in a larger nationwide cohort.
We examined the 2-year mortality in relation to the AB scores in 3483 patients from a Japanese nationwide cohort and attempted to stratify their prognoses according to the scores. The AB score was determined by assigning points for age, anemia, and brain natriuretic peptide (BNP) level at discharge: age (<65 years, 0; 65-74 years, 1; ≥75 years, 2), anemia (hemoglobin ≥12 g/dL, 0; 10-11.9 g/dL, 1; <10 g/dL, 2), and BNP (<200 pg/mL, 0; 200-499 pg/mL, 1; ≥500 pg/mL, 2). Hemoglobin and BNP levels were applied to the data at discharge. The 2-year survival rates for AB scores 1, 2, 3, 4, 5, and 6 were 94.1%, 83.2%, 74.1%, 63.5%, 51.6%, and 41.5%, respectively; the mortality rate increased by ≈10% for each point increase (c-index, 0.702). The AB score was applicable in HF cases with reduced or preserved ejection fraction and remained useful when BNP was substituted with N-terminal proBNP (c-index, 0.749, 0.676, and 0.682, respectively).
The AB score showed a good prognostic value for HF in a large population even when BNP was replaced with N-terminal proBNP.
虽然在心力衰竭（HF）病例中，需要一种供全体医务人员共享患者预后情况的工具，但目前仅有少数简单的HF预后评分。我们之前提出了AB评分，这是一种简单且便于使用的HF风险评分，并在一个小型单中心队列中对其进行了验证。在本研究中，我们在一个更大的全国性队列中对其进行了验证。
我们在一个日本全国性队列的3483例患者中，研究了与AB评分相关的2年死亡率，并尝试根据评分对他们的预后进行分层。AB评分通过对年龄、贫血情况以及出院时的脑钠肽（BNP）水平赋分来确定：年龄（<65岁，0分；65 - 74岁，1分；≥75岁，2分），贫血（血红蛋白≥12 g/dL，0分；10 - 11.9 g/dL，1分；<10 g/dL，2分），以及BNP（<200 pg/mL，0分；200 - 499 pg/mL，1分；≥500 pg/mL，2分）。血红蛋白和BNP水平采用出院时的数据。AB评分1、2、3、4、5和6分的患者2年生存率分别为94.1%、83.2%、74.1%、63.5%、51.6%和41.5%；每增加1分，死亡率约增加10%（c指数为0.702）。AB评分适用于射血分数降低或保留的HF病例，并且当用N末端脑钠肽原（NT-proBNP）替代BNP时仍然有效（c指数分别为0.749、0.676和0.682）。
即使将BNP替换为NT-proBNP，AB评分在大量人群中对HF仍显示出良好的预后价值。
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