Wu Xuefeng, Li Jianming, Xu Zhaoyan, Feng Yingqing
Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Department of Cardiology, The First People's Hospital of Foshan, Foshan, China.
Int J Cardiol Heart Vasc. 2025 Mar 22;58:101655. doi: 10.1016/j.ijcha.2025.101655. eCollection 2025 Jun.
Coronary artery disease (CAD) is a significant risk factor for heart failure with preserved ejection fraction (HFpEF). While the HFA-PEFF and H2FPEF scoring systems were developed to aid in the diagnosis of HFpEF, their predictive performance in patients with CAD remains underexplored.
This single-center retrospective cohort study included patients who underwent drug-eluting stent implantation between January 2018 and October 2022. The study's primary endpoint was a composite outcome of all-cause mortality and heart failure hospitalization during follow-up. Kaplan-Meier survival curves were used to evaluate time to adverse events, and differences between groups were analyzed using the log-rank test. Cox proportional hazards regression was applied to assess the independent predictive value of the HFA-PEFF and H2FPEF scores for adverse outcomes.
The HFA-PEFF score categorized 65.7 % of patients as intermediate, 25.1 % as high, and 9.2 % as low probability for HFpEF. The H2FPEF score placed 77.3 % in the intermediate group, 19.3 % in the low, and 3.4 % in the high-probability group. The median follow-up period was 29 months. Adjusted Cox proportional hazard regression revealed the HFA-PEFF score was significantly associated with the composite endpoint of all-cause mortality and heart failure hospitalization (HR: 1.33, 95 % CI:1.07-1.65). Each point increase in the HFA-PEFF score raised heart failure hospitalization risk by 26 % (HR:1.26, 95 % CI: 1.05-1.51). In contrast, the H2FPEF score did not show a significant association with adverse events.
The HFA-PEFF score demonstrated superior prognostic value for predicting adverse outcomes in CAD patients with preserved ejection fraction compared to the H2FPEF score.
冠状动脉疾病（CAD）是射血分数保留的心力衰竭（HFpEF）的重要危险因素。虽然HFA-PEFF和H2FPEF评分系统是为辅助HFpEF的诊断而开发的，但其在CAD患者中的预测性能仍未得到充分研究。
这项单中心回顾性队列研究纳入了2018年1月至2022年10月期间接受药物洗脱支架植入的患者。该研究的主要终点是随访期间全因死亡率和心力衰竭住院的复合结局。采用Kaplan-Meier生存曲线评估不良事件发生时间，并使用对数秩检验分析组间差异。应用Cox比例风险回归评估HFA-PEFF和H2FPEF评分对不良结局的独立预测价值。
HFA-PEFF评分将65.7%的患者归类为HFpEF中度可能性，25.1%为高度可能性，9.2%为低度可能性。H2FPEF评分将77.3%的患者归为中度组，19.3%归为低度组，3.4%归为高度组。中位随访期为29个月。调整后的Cox比例风险回归显示，HFA-PEFF评分与全因死亡率和心力衰竭住院的复合终点显著相关（HR：1.33，95%CI：1.07-1.65）。HFA-PEFF评分每增加1分，心力衰竭住院风险增加26%（HR：1.26，95%CI：1.05-1.51）。相比之下，H2FPEF评分与不良事件无显著关联。
与H2FPEF评分相比，HFA-PEFF评分在预测射血分数保留的CAD患者不良结局方面显示出更高的预后价值。
