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Comparison of risk scores in patients undergoing cardiac resynchronization therapy

Session Poster session 3

Speaker Andras Mihaly Boros

Congress : EHRA 2019

  • Topic : arrhythmias and device therapy
  • Sub-topic : Cardiac Resynchronization Therapy
  • Session type : Poster Session
  • FP Number : P1532

Authors : A M Boros (Budapest,HU), P Perge (Budapest,HU), L Geller (Budapest,HU), B Merkely (Budapest,HU), G Szeplaki (Budapest,HU)

A M Boros1 , P Perge1 , L Geller1 , B Merkely1 , G Szeplaki1 , 1Semmelweis University Heart Center, Cardiology - Budapest - Hungary ,


Cardiac resynchronization therapy (CRT) improves the mortality of heart failure, though it remains rather high. Several risk scores have been established to present the long-term benefit of the procedure more realistically.

We created the "REDNaILER score" and compared its discriminative power to that of other risk scores including "AL-FINE", "EAARN", "VALID-CRT", "CRT-score", and "Screen".

We retrospectively analyzed the utility of the above score systems in the prediction of 5-year mortality in 136 consecutive patients undergoing CRT. The "REDNaILER score" is the combination of baseline predictors that have been previously described by our group: REd blood cell Distribution width > 13.35%, NeutrophIl granulocyte to the LymphocytE Ratio > 2.95, lack of left bundle branch block morphology, lack of beta blocker therapy. The presence of any of these variables equals to 1 point. Patients were categorized into low (0-1 points), medium (2 points) and high (3-4) risk groups.

After a median follow-up of 1799 (861-2023) days, 58 patients (42%) died. The discriminative power of the REDNaILER score [c-statistics: 0.74 (0.66-0.82); log-rank p<0.0001] showed comparable performance to AL-FINE [DeLong p=0.17; c-statistics: 0.67 (0.59-0.75); log-rank p<0.0001], EAARN [DeLong p=0.005; c-statistics: 0.59 (0.50-0.67); log-rank p=0.02], VALID-CRT [DeLong p=0.05; c-statistics: 0.65 (0.58-0.72); log-rank p<0.0001], CRT-score [DeLong p=0.16; c-statistics: 0.67 (0.59-0.74); log-rank p<0.0001], and Screen [DeLong p=0.002; c-statistics: 0.57 (0.49-0.66); log-rank p=0.06].

We validated the utility of "AL-FINE", "EAARN", "VALID-CRT", "CRT-score", and "Screen" scores in our CRT patient population and presented the novel "REDNaILER score" that has adequate discriminative power.

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