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A Novel In-hospital Congestion Score to Risk Stratify Patients Admitted for Worsening Heart Failure (from ASCEND-HF).

Publication ,  Journal Article
Masson, R; Ambrosy, AP; Kheder, K; Fudim, M; Clare, RM; Coles, A; Hernandez, AF; Starling, RC; Ezekowitz, JA; O'Connor, CM; Mentz, RJ
Published in: J Cardiovasc Transl Res
August 2020

Patients hospitalized for heart failure (HF) remain at high risk for early readmission. A post hoc analysis was performed of the biomarker substudy of the ASCEND-HF trial. An in-hospital congestion score was derived using orthopnea, pedal edema, and NT-proBNP levels. Its added prognostic value beyond traditional risk factors was assessed by determining the net reclassification index (NRI). Study participants (n = 884) had a median age (years) of 67 (55-77), 68% were male, and the median (25th-75th) ejection fraction (%) was 26 (20-40). After adjustment, increasing congestion score was associated with 30-day all-cause mortality or HF hospitalization (odds ratio = 1.51, 95% confidence interval [CI] 1.28-1.77, p < 0.001) and 180-day all-cause mortality (hazard ratio = 1.48, 95% CI 1.28-1.72, p < 0.001). However, adding the congestion score to the multivariable model did not significantly impact the NRI. A higher in-hospital congestion score portended a poor short-term prognosis but did not significantly reclassify risk.

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Published In

J Cardiovasc Transl Res

DOI

EISSN

1937-5395

Publication Date

August 2020

Volume

13

Issue

4

Start / End Page

540 / 548

Location

United States

Related Subject Headings

  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Randomized Controlled Trials as Topic
  • Prognosis
  • Predictive Value of Tests
  • Peptide Fragments
  • Patient Readmission
  • Patient Admission
  • Natriuretic Peptide, Brain
 

Citation

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Masson, R., Ambrosy, A. P., Kheder, K., Fudim, M., Clare, R. M., Coles, A., … Mentz, R. J. (2020). A Novel In-hospital Congestion Score to Risk Stratify Patients Admitted for Worsening Heart Failure (from ASCEND-HF). J Cardiovasc Transl Res, 13(4), 540–548. https://doi.org/10.1007/s12265-020-09954-x
Masson, Rajeev, Andrew P. Ambrosy, Kevin Kheder, Marat Fudim, Robert M. Clare, Adrian Coles, Adrian F. Hernandez, et al. “A Novel In-hospital Congestion Score to Risk Stratify Patients Admitted for Worsening Heart Failure (from ASCEND-HF).J Cardiovasc Transl Res 13, no. 4 (August 2020): 540–48. https://doi.org/10.1007/s12265-020-09954-x.
Masson R, Ambrosy AP, Kheder K, Fudim M, Clare RM, Coles A, et al. A Novel In-hospital Congestion Score to Risk Stratify Patients Admitted for Worsening Heart Failure (from ASCEND-HF). J Cardiovasc Transl Res. 2020 Aug;13(4):540–8.
Masson, Rajeev, et al. “A Novel In-hospital Congestion Score to Risk Stratify Patients Admitted for Worsening Heart Failure (from ASCEND-HF).J Cardiovasc Transl Res, vol. 13, no. 4, Aug. 2020, pp. 540–48. Pubmed, doi:10.1007/s12265-020-09954-x.
Masson R, Ambrosy AP, Kheder K, Fudim M, Clare RM, Coles A, Hernandez AF, Starling RC, Ezekowitz JA, O’Connor CM, Mentz RJ. A Novel In-hospital Congestion Score to Risk Stratify Patients Admitted for Worsening Heart Failure (from ASCEND-HF). J Cardiovasc Transl Res. 2020 Aug;13(4):540–548.
Journal cover image

Published In

J Cardiovasc Transl Res

DOI

EISSN

1937-5395

Publication Date

August 2020

Volume

13

Issue

4

Start / End Page

540 / 548

Location

United States

Related Subject Headings

  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Randomized Controlled Trials as Topic
  • Prognosis
  • Predictive Value of Tests
  • Peptide Fragments
  • Patient Readmission
  • Patient Admission
  • Natriuretic Peptide, Brain