CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

Age-Related Characteristics and Outcomes of Patients With Heart Failure With Preserved Ejection Fraction Burden of Cardiovascular Diseases in China, 1990-2016: Findings From the 2016 Global Burden of Disease Study Coronary plaque redistribution after stent implantation is determined by lipid composition: A NIRS-IVUS analysis Baseline Features of the VICTORIA (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction) Trial Association of Abnormal Left Ventricular Functional Reserve With Outcome in Heart Failure With Preserved Ejection Fraction Heart Failure and Atrial Fibrillation, Like Fire and Fury Modifiable lifestyle factors and heart failure: A Mendelian randomization study Natriuretic Peptide-Guided Heart Failure Therapy After the GUIDE-IT Study Comparison of paclitaxel-eluting stents (Taxus) and everolimus-eluting stents (Xience) in left main coronary artery disease with 3 years follow-up (from the ESTROFA-LM registry) Permanent pacemaker use among patients with heart failure and preserved ejection fraction: Findings from the Acute Decompensated Heart Failure National Registry (ADHERE) National Registry

Clinical TrialVolume 6, Issue 9, September 2018

JOURNAL:JACC: Heart Failure Article Link

INTERMACS Profiles and Outcomes Among Non–Inotrope-Dependent Outpatients With Heart Failure and Reduced Ejection Fraction

A Samman-Tahhan, JS Hedley, AA. McCue et al. Keywords: heart failure; heart failure with reduced ejection fraction; HFrEF; INTERMACS; outcomes

ABSTRACT


OBJECTIVES - This study sought to evaluate INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) profiles for prognostic use among ambulatory non–inotrope-dependent patients with heart failure with reduced ejection fraction (HFrEF).

BACKGROUND - Data for INTERMACS profiles and prognoses in ambulatory patients with HFrEF are limited.

METHODS - We evaluated 3-year outcomes in 969 non–inotrope-dependent outpatients with HFrEF (EF: ≤40%) not previously receiving advanced HF therapies. Patients meeting an INTERMACS profile at baseline were classified as profile 7 (n = 348 [34.7%]); 146 patients (14.5%) were classified profile 6; and 52 patients (5.2%) were classified profile 4 to 5. Remaining patients were classified “stable Stage C” (n = 423 [42.1%]).

RESULTS -  Three-year mortality rate was 10.0% among stable Stage C patients compared with 21.8% among INTERMACS profile 7 (hazard ratio [HR] vs. Stage C: 2.45; 95% confidence interval [CI]: 1.64 to 3.66), 26.0% among profile 6 (HR: 3.93; 95% CI: 1.64 to 3.66), and 43.8% among profile 4 to 5 (HR: 6.35; 95% CI: 3.51 to 11.5) patients. Hospitalization rates for HF were 4-fold higher among INTERMACS profile 7 (38 per 100 patient-years; rate ratio [RR] vs. Stage C: 3.88; 95% CI: 2.70 to 5.35), 6-fold higher among profile 6 patients (54 per 100 patient-years; RR: 5.69; 95% CI: 3.72 to 8.71), and 10-fold higher among profile 4 to 5 patients (69 per 100 patient-years; RR: 9.96; 95% CI: 5.15 to 19.3) than stable Stage C patients (11 per 100 patient-years). All-cause hospitalization rates had similar trends. INTERMACS profiles offered better prognostic separation than NYHA functional classifications.

CONCLUSIONS - INTERMACS profiles strongly predict subsequent mortality and hospitalization burden in non–inotrope-dependent outpatients with HFrEF. These simple profiles could therefore facilitate and promote advanced HF awareness among clinicians and planning for advanced HF therapies.