Simple risk score to predict survival in acute decompensated heart failure: A2B score

Yasuki Nakada, Rika Kawakami, Shouji Matsushima, Tomomi Ide, Koshiro Kanaoka, Tomoya Ueda, Satomi Ishihara, Taku Nishida, Kenji Onoue, Tsunenari Soeda, Satoshi Okayama, Makoto Watanabe, Hiroyuki Okura, Miyuki Tsuchihashi-Makaya, Hiroyuki Tsutsui, Yoshihiko Saito

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Prognosis after acute decompensated heart failure (ADHF) is poor. An appropriate risk score that would allow for improved care and treatment of ADHF patients after discharge, however, is lacking. Methods and Results: We used 2 HF cohorts, the NARA-HF study and JCARE-CARD, as derivation and validation cohorts, respectively. The primary endpoint was all-cause death during the 2-year follow-up, excluding in-hospital death. Age, hemoglobin (Hb), and brain natriuretic peptide (BNP) at discharge were identified as independent risk factors. We determined 3 categorizations on the basis of these parameters, termed A2B score: age (<65 years, 0; 65-74 years, 1; ≥75 years, 2), anemia (Hb <10 g/dL, 2; 10-11.9 g/dL, 1; ≥12 g/dL, 0) and BNP (<200 pg/mL, 0; 200-499 pg/mL, 1; ≥500 pg/mL, 2). We divided patients into 4 groups according to A2B score (extremely low, 0; low, 1-2; medium, 3-4; high, 5-6). For the extremely low-risk group, the 2-year survival rate was 97.8%, compared with 84.5%, 66.1%, and 45.2% for the low-, medium-, and high-risk groups, respectively. Using the JCARE-CARD as a validation model, for the extremely low-risk group, the 2-year survival was 95.4%, compared with 90.2%, 75.0%, and 55.6% for the low-, medium-, and high-risk groups, respectively. Conclusions: The user-friendly A2B score is useful for estimating survival rate in ADHF patients at discharge.

Original languageEnglish
Pages (from-to)1019-1024
Number of pages6
JournalCirculation Journal
Volume83
Issue number5
DOIs
Publication statusPublished - 2019

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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