SHODA Morio    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Endowed Professor
Article types	Original article
Language	English
Peer review	Non peer reviewed
Title	Cardio-renal and cardio-hepatic interactions predict cardiovascular events in elderly patients with heart failure.
Journal	Formal name：PloS one Abbreviation：PLoS One ISSN code：19326203/19326203
Domestic / Foregin	Foregin
Volume, Issue, Page	15(10),pp.e0241003
Author and coauthor	Okano Takahiro, Motoki Hirohiko, Minamisawa Masatoshi, Kimura Kazuhiro, Kanai Masafumi, Yoshie Koji, Higuchi Satoko, Saigusa Tatsuya, Ebisawa Soichiro, Okada Ayako, Shoda Morio, Kuwahara Koichiro
Publication date	2020/10
Summary	BACKGROUND:The composite Model for End-Stage Liver Disease Excluding International Normalized Ratio Score (MELD-XI) is a novel tool to evaluate cardio-renal and cardio-hepatic interactions in patients with advanced heart failure (HF). However, its prognostic ability remains unclear in elderly HF patients.METHODS AND RESULTS:From July 2014 to July 2018, patients hospitalized for HF were prospectively recruited at 16 centers. Clinical features, laboratory findings, and echocardiography results were assessed prior to discharge. Cardiovascular (CV) death and HF re-hospitalization were recorded. Of the 676 patients enrolled, 264 (39.1%) experienced CV events throughout a 1-year median follow-up period. Patients with high MELD-XI were predominantly male and had a higher prevalence of NYHA III/IV, history of HF admission, hyperuricemia, ventricular tachycardia, anemia, and ischemic heart disease. In Kaplan-Meyer analysis, patients with higher MELD-XI (≥11) scores showed a worse prognosis than did those with lower (<11) scores (log-rank p≤0.001). Multivariate Cox proportional hazards testing revealed MELD-XI as an independent predictor of CV events (HR: 1.033, 95% CI: 1.006-1.061, p = 0.015) after adjusting for age, gender, body mass index, NYHA III/IV, prior HF hospitalization, systolic blood pressure, ischemic etiology, ventricular tachycardia, anemia, BNP, and left ventricular ejection fraction.CONCLUSIONS:Cardio-renal and cardio-hepatic interactions predicted CV events in aged HF patients.
DOI	10.1371/journal.pone.0241003
PMID	33095810