D'Amato Andrea, Severino Paolo, Mancone Massimo, Mariani Marco Valerio, Prosperi Silvia, Colombo Lorenzo, Myftari Vincenzo, Cestiè Claudia, Labbro Francia Aurora, Germanò Rosanna, Pierucci Nicola, Fanisio Francesca, Marek-Iannucci Stefanie, De Prisco Andrea, Scoccia Gianmarco, Birtolo Lucia Ilaria, Manzi Giovanna, Lavalle Carlo, Sardella Gennaro, Badagliacca Roberto, Fedele Francesco, Vizza Carmine Dario
Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
Division of Cardiology, Policlinico Casilino, 00169 Rome, Italy.
J Clin Med. 2024 Jun 4;13(11):3322. doi: 10.3390/jcm13113322.
Ischemic heart disease (IHD) represents the main cause of heart failure (HF). A prognostic stratification of HF patients with ischemic etiology, particularly those with acute coronary syndrome (ACS), may be challenging due the variability in clinical and hemodynamic status. The aim of this study is to assess the prognostic power of the HLM score in a population of patients with ischemic HF and in a subgroup who developed HF following ACS. This is an observational, prospective, single-center study, enrolling consecutive patients with a diagnosis of ischemic HF. Patients were stratified according to the four different HLM stages of severity, and the occurrence of CV death, HFH, and worsening HF events were evaluated at 6-month follow-up. A sub-analysis was performed on patients who developed HF following ACS at admission. The study included 146 patients. HLM stage predicts the occurrence of CV death ( = 0.01) and CV death/HFH ( = 0.003). Cox regression analysis confirmed HLM stage as an independent predictor of CV death (OR: 3.07; 95% IC: 1.54-6.12; = 0.001) and CV death/HFH (OR: 2.45; 95% IC: 1.43-4.21; = 0.001) in the total population of patients with HF due to IHD. HLM stage potentially predicts the occurrence of CV death ( < 0.001) and CV death/HFH ( < 0.001) in patients with HF following ACS at admission. Pathophysiological-based prognostic assessment through HLM score is a potentially promising tool for the prediction of the occurrence of CV death and CV death/HFH in ischemic HF patients and in subgroups of patients with HF following ACS at admission.
缺血性心脏病（IHD）是心力衰竭（HF）的主要原因。对患有缺血性病因的HF患者，尤其是患有急性冠状动脉综合征（ACS）的患者进行预后分层，可能因临床和血流动力学状态的变异性而具有挑战性。本研究的目的是评估HLM评分在缺血性HF患者群体以及ACS后发生HF的亚组中的预后预测能力。这是一项观察性、前瞻性、单中心研究，纳入连续诊断为缺血性HF的患者。患者根据HLM严重程度的四个不同阶段进行分层，并在6个月随访时评估心血管死亡、因心力衰竭住院（HFH）和HF恶化事件的发生情况。对入院时因ACS发生HF的患者进行了亚分析。该研究纳入了146名患者。HLM阶段可预测心血管死亡的发生（P = 0.01）和心血管死亡/HFH（P = 0.003）。Cox回归分析证实，HLM阶段是IHD所致HF患者总体人群中心血管死亡（OR：3.07；95%CI：1.54 - 6.12；P = 0.001）和心血管死亡/HFH（OR：2.45；95%CI：1.43 - 4.21；P = 0.001）的独立预测因素。HLM阶段可能预测入院时因ACS发生HF的患者中心血管死亡（P < 0.001）和心血管死亡/HFH（P < 0.001）的发生。通过HLM评分进行基于病理生理学的预后评估，对于预测缺血性HF患者以及入院时因ACS发生HF的患者亚组中心血管死亡和心血管死亡/HFH的发生是一种潜在的有前景的工具。
