Independent prognostic value of the congestion and renal index in patients with acute heart failure.
10.26599/1671-5411.2023.07.006
- Author:
Run-Qing JI
1
;
Bin WANG
1
;
Jin-Guo ZHANG
2
;
Shu-Hong SU
3
;
Li LI
4
;
Qin YU
5
;
Xian-Yan JIANG
6
;
Xin FU
7
;
Xue-Hua FANG
8
;
Xiao-Wen MA
9
;
Ao-Xi TIAN
1
;
Jing LI
1
Author Information
1. National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China.
2. Department of Cardiology, Affiliated Hospital of Jining Medical University, Jining, China.
3. Department of Cardiology, Xinxiang Central Hospital, Xinxiang, China.
4. Department of Cardiology, Shanxi Fenyang Hospital, Fenyang, China.
5. Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.
6. Heart Center, Qingdao Fuwai Cardiovascular Hospital, Qingdao, China.
7. Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
8. Department of Cardiology, Beijing Liangxiang Hospital, Beijing, China.
9. Department of Cardiology, Qinyang People's Hospital, Qinyang, China.
- Publication Type:Journal Article
- From:
Journal of Geriatric Cardiology
2023;20(7):516-526
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Clinical outcomes are poor if patients with acute heart failure (AHF) are discharged with residual congestion in the presence of renal dysfunction. However, there is no single indication to reflect the combined effects of the two related pathophysiological processes. We, therefore, proposed an indicator, congestion and renal index (CRI), and examined the associations between the CRI and one-year outcomes and the incremental prognostic value of CRI compared with the established scoring systems in a multicenter prospective cohort of AHF.
METHODS:We enrolled AHF patients and calculated the ratio of thoracic fluid content index divided by estimated glomerular filtration rate before discharge, as CRI. Then we examined the associations between CRI and one-year outcomes.
RESULTS:A total of 944 patients were included in the analysis (mean age 63.3 ± 13.8 years, 39.3% women). Compared with patients with CRI ≤ 0.59 mL/min per kΩ, those with CRI > 0.59 mL/min per kΩ had higher risks of cardiovascular death or HF hospitalization (HR = 1.56 [1.13-2.15]) and all-cause death or all-cause hospitalization (HR = 1.33 [1.01-1.74]). CRI had an incremental prognostic value compared with the established scoring system.
CONCLUSIONS:In patients with AHF, CRI is independently associated with the risk of death or hospitalization within one year, and improves the risk stratification of the established risk models.
