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 / ForeginForegin
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