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Implications of Alternative Hepatorenal Prognostic Scoring Systems in Acute Heart Failure (from DOSE-AHF and ROSE-AHF).

Publication ,  Journal Article
Grodin, JL; Gallup, D; Anstrom, KJ; Felker, GM; Chen, HH; Tang, WHW
Published in: Am J Cardiol
June 15, 2017

Because hepatic dysfunction is common in patients with heart failure (HF), the Model for End-Stage Liver Disease (MELD) may be attractive for risk stratification. Although alternative scores such as the MELD-XI or MELD-Na may be more appropriate in HF populations, the short-term clinical implications of these in patients with acute heart failure (AHF) are unknown. The MELD-XI and MELD-Na were calculated at baseline in 453 patients with AHF in the DOSE-AHF and ROSE-AHF trials. The correlations and associations for each score with cardiorenal biomarkers, short-term end points at 72 hours including worsening renal function and clinical events to 60 days were determined. The median MELD-XI and MELD-Na was 16 and 17, respectively. Both were correlated with baseline cystatin C, amino terminus pro-B-type natriuretic peptide, and plasma renin activity (p <0.003 for all). MELD-XI ≤16 and MELD-Na ≤17 were associated with a slight increase in cystatin C (p <0.02 for both), higher diuretic efficiency (p <0.001 for both), but not with change in global visual assessment scores (p >0.05 for both) at 72 hours. Neither score was associated with worsening renal function or worsening HF (p >0.05 for all). Similarly, both the MELD-XI and MELD-Na were not associated with 60-day death/any rehospitalization and 60-day death/HF rehospitalization in adjusted analyses when analyzes as a dichotomous or continuous variable (p >0.05 for all). In conclusion, the alternative MELD scores correlated with baseline cardiorenal biomarkers, and lower baseline MELD scoring was associated with higher diuretic efficiency and a slight increase in cystatin C through 72 hours. However, MELD-Na and MELD-XI were not predictive of 60-day clinical events.

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Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

June 15, 2017

Volume

119

Issue

12

Start / End Page

2003 / 2009

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Sodium
  • Severity of Illness Index
  • Risk Assessment
  • Renal Insufficiency
  • Prognosis
  • Male
  • Liver Failure
 

Citation

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ICMJE
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Grodin, J. L., Gallup, D., Anstrom, K. J., Felker, G. M., Chen, H. H., & Tang, W. H. W. (2017). Implications of Alternative Hepatorenal Prognostic Scoring Systems in Acute Heart Failure (from DOSE-AHF and ROSE-AHF). Am J Cardiol, 119(12), 2003–2009. https://doi.org/10.1016/j.amjcard.2017.03.031
Grodin, Justin L., Dianne Gallup, Kevin J. Anstrom, G Michael Felker, Horng H. Chen, and WH Wilson Tang. “Implications of Alternative Hepatorenal Prognostic Scoring Systems in Acute Heart Failure (from DOSE-AHF and ROSE-AHF).Am J Cardiol 119, no. 12 (June 15, 2017): 2003–9. https://doi.org/10.1016/j.amjcard.2017.03.031.
Grodin JL, Gallup D, Anstrom KJ, Felker GM, Chen HH, Tang WHW. Implications of Alternative Hepatorenal Prognostic Scoring Systems in Acute Heart Failure (from DOSE-AHF and ROSE-AHF). Am J Cardiol. 2017 Jun 15;119(12):2003–9.
Grodin, Justin L., et al. “Implications of Alternative Hepatorenal Prognostic Scoring Systems in Acute Heart Failure (from DOSE-AHF and ROSE-AHF).Am J Cardiol, vol. 119, no. 12, June 2017, pp. 2003–09. Pubmed, doi:10.1016/j.amjcard.2017.03.031.
Grodin JL, Gallup D, Anstrom KJ, Felker GM, Chen HH, Tang WHW. Implications of Alternative Hepatorenal Prognostic Scoring Systems in Acute Heart Failure (from DOSE-AHF and ROSE-AHF). Am J Cardiol. 2017 Jun 15;119(12):2003–2009.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

June 15, 2017

Volume

119

Issue

12

Start / End Page

2003 / 2009

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Sodium
  • Severity of Illness Index
  • Risk Assessment
  • Renal Insufficiency
  • Prognosis
  • Male
  • Liver Failure