Simple risk score to predict survival in acute decompensated heart failure

A2B score

Yasuki Nakada, Rika Kawakami, Shoji 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 journalArticle

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 - Jan 1 2019

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Heart Failure
Survival
Patient Discharge
Brain Natriuretic Peptide
Hemoglobins
Survival Rate
Anemia
Cause of Death
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Simple risk score to predict survival in acute decompensated heart failure : A2B score. / Nakada, Yasuki; Kawakami, Rika; Matsushima, Shoji; Ide, Tomomi; Kanaoka, Koshiro; Ueda, Tomoya; Ishihara, Satomi; Nishida, Taku; Onoue, Kenji; Soeda, Tsunenari; Okayama, Satoshi; Watanabe, Makoto; Okura, Hiroyuki; Tsuchihashi-Makaya, Miyuki; Tsutsui, Hiroyuki; Saito, Yoshihiko.

In: Circulation Journal, Vol. 83, No. 5, 01.01.2019, p. 1019-1024.

Research output: Contribution to journalArticle

Nakada, Y, Kawakami, R, Matsushima, S, Ide, T, Kanaoka, K, Ueda, T, Ishihara, S, Nishida, T, Onoue, K, Soeda, T, Okayama, S, Watanabe, M, Okura, H, Tsuchihashi-Makaya, M, Tsutsui, H & Saito, Y 2019, 'Simple risk score to predict survival in acute decompensated heart failure: A2B score', Circulation Journal, vol. 83, no. 5, pp. 1019-1024. https://doi.org/10.1253/circj.CJ-18-1116
Nakada, Yasuki ; Kawakami, Rika ; Matsushima, Shoji ; Ide, Tomomi ; Kanaoka, Koshiro ; Ueda, Tomoya ; Ishihara, Satomi ; Nishida, Taku ; Onoue, Kenji ; Soeda, Tsunenari ; Okayama, Satoshi ; Watanabe, Makoto ; Okura, Hiroyuki ; Tsuchihashi-Makaya, Miyuki ; Tsutsui, Hiroyuki ; Saito, Yoshihiko. / Simple risk score to predict survival in acute decompensated heart failure : A2B score. In: Circulation Journal. 2019 ; Vol. 83, No. 5. pp. 1019-1024.
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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.",
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T1 - Simple risk score to predict survival in acute decompensated heart failure

T2 - A2B score

AU - Nakada, Yasuki

AU - Kawakami, Rika

AU - Matsushima, Shoji

AU - Ide, Tomomi

AU - Kanaoka, Koshiro

AU - Ueda, Tomoya

AU - Ishihara, Satomi

AU - Nishida, Taku

AU - Onoue, Kenji

AU - Soeda, Tsunenari

AU - Okayama, Satoshi

AU - Watanabe, Makoto

AU - Okura, Hiroyuki

AU - Tsuchihashi-Makaya, Miyuki

AU - Tsutsui, Hiroyuki

AU - Saito, Yoshihiko

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

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U2 - 10.1253/circj.CJ-18-1116

DO - 10.1253/circj.CJ-18-1116

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JF - Circulation Journal

SN - 1346-9843

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