Journal of Clinical Medicine (Dec 2023)
Exploring the Prognostic Performance of MECKI Score in Heart Failure Patients with Non-Valvular Atrial Fibrillation Treated with Edoxaban
- Massimo Mapelli,
- Irene Mattavelli,
- Elisabetta Salvioni,
- Nicolò Capra,
- Alice Bonomi,
- Gaia Cattadori,
- Beatrice Pezzuto,
- Jeness Campodonico,
- Arianna Piotti,
- Alessandro Nava,
- Massimo Piepoli,
- Damiano Magrì,
- Stefania Paolillo,
- Ugo Corrà,
- Rosa Raimondo,
- Rocco Lagioia,
- Carlo Vignati,
- Roberto Badagliacca,
- Pasquale Perrone Filardi,
- Michele Senni,
- Michele Correale,
- Mariantonietta Cicoira,
- Marco Metra,
- Marco Guazzi,
- Giuseppe Limongelli,
- Gianfranco Parati,
- Fabiana De Martino,
- Francesco Bandera,
- Maurizio Bussotti,
- Federica Re,
- Carlo M. Lombardi,
- Angela B. Scardovi,
- Susanna Sciomer,
- Andrea Passantino,
- Michele Emdin,
- Caterina Santolamazza,
- Enrico Perna,
- Claudio Passino,
- Gianfranco Sinagra,
- Piergiuseppe Agostoni
Affiliations
- Massimo Mapelli
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy
- Irene Mattavelli
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy
- Elisabetta Salvioni
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy
- Nicolò Capra
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy
- Alice Bonomi
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy
- Gaia Cattadori
- Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, 20122 Milan, Italy
- Beatrice Pezzuto
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy
- Jeness Campodonico
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy
- Arianna Piotti
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy
- Alessandro Nava
- University of Trieste, 34127 Trieste, Italy
- Massimo Piepoli
- Clinical Cardiology, IRCCS, Policlinico San Donato, 20097 San Donato Milanese, Italy
- Damiano Magrì
- Department of Clinical and Molecular Medicine, Azienda Ospedaliera Sant’Andrea, “Sapienza” Università degli Studi di Roma, 00185 Rome, Italy
- Stefania Paolillo
- IRCCS SDN, Istituto di Ricerca, 80143 Napoli, Italy
- Ugo Corrà
- Cardiology Department, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno Institute, 28010 Veruno, Italy
- Rosa Raimondo
- Divisione di Cardiologia Riabilitativa, Istituti Clinici Scientifici Maugeri, IRCCS, 21049 Tradate, Italy
- Rocco Lagioia
- UOC Cardiologia di Riabilitativa, Mater Dei Hospital, 70125 Bari, Italy
- Carlo Vignati
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy
- Roberto Badagliacca
- Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, “Sapienza”, Rome University, 00185 Rome, Italy
- Pasquale Perrone Filardi
- Department of Advanced Biomedical Sciences, “Federico II” University, 80138 Napoli, Italy
- Michele Senni
- Cardiology Unit, Cardiovascular Department, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
- Michele Correale
- Department of Cardiology, University of Foggia, 71122 Foggia, Italy
- Mariantonietta Cicoira
- Poliambulatorio San Gaetano, 36016 Thiene, Italy
- Marco Metra
- Institute of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, 25121 Brescia, Italy
- Marco Guazzi
- Dipartimento di Scienze Biomediche per la Salute, Ospedale San Paolo, Università Degli Studi di Milano, 20122 Milan, Italy
- Giuseppe Limongelli
- Cardiologia SUN, Ospedale Monaldi (Azienda dei Colli), Seconda Università di Napoli, 80138 Napoli, Italy
- Gianfranco Parati
- Istituto Auxologico Italiano, IRCCS, 20138 Milan, Italy
- Fabiana De Martino
- Unità Funzionale di Cardiologia, Casa di Cura Tortorella, 84124 Salerno, Italy
- Francesco Bandera
- Department Biomedical Sciences for Health, University of Milan, 20122 Milan, Italy
- Maurizio Bussotti
- Cardiac Rehabilitation Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Milan, 20138 Milan, Italy
- Federica Re
- Cardiology Division, Cardiac Arrhythmia Center and Cardiomyopathies Unit, San Camillo-Forlanini Hospital, 00152 Rome, Italy
- Carlo M. Lombardi
- Institute of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, 25121 Brescia, Italy
- Angela B. Scardovi
- Cardiology Division, Santo Spirito Hospital, 00193 Rome, Italy
- Susanna Sciomer
- Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, “Sapienza”, Rome University, 00185 Rome, Italy
- Andrea Passantino
- Division of Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Institute of Bari, 70124 Bari, Italy
- Michele Emdin
- Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
- Caterina Santolamazza
- Dipartimento Cardio-Toraco-Vascolare, Ospedale Cà Granda-A.O. Niguarda, 20162 Milan, Italy
- Enrico Perna
- Dipartimento Cardio-Toraco-Vascolare, Ospedale Cà Granda-A.O. Niguarda, 20162 Milan, Italy
- Claudio Passino
- Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
- Gianfranco Sinagra
- Cardiovascular Department, “Azienda Sanitaria Universitaria Giuliano-Isontina”, 34100 Trieste, Italy
- Piergiuseppe Agostoni
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy
- DOI
- https://doi.org/10.3390/jcm13010094
- Journal volume & issue
-
Vol. 13,
no. 1
p. 94
Abstract
Introduction: Risk stratification in heart failure (HF) is essential for clinical and therapeutic management. The Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score is a validated prognostic model for assessing cardiovascular risk in HF patients with reduced ejection fraction (HFrEF). From the validation of the score, the prevalence of HF patients treated with direct oral anticoagulants (DOACs), such as edoxaban, for non-valvular atrial fibrillation (NVAF) has been increasing in recent years. This study aims to evaluate the reliability of the MECKI score in HFrEF patients treated with edoxaban for NVAF. Materials and Methods: This study included consecutive outpatients with HF and NVAF treated with edoxaban (n = 83) who underwent a cardiopulmonary exercise test (CPET). They were matched by propensity score with a retrospective group of HFrEF patients with NVAF treated with vitamin K antagonists (VKAs) from the MECKI score registry (n = 844). The study endpoint was the risk of cardiovascular mortality, urgent heart transplantation, or Left Ventricle Assist Device (LVAD) implantation. Results: Edoxaban patients were treated with a more optimized HF therapy and had different clinical characteristics, with a similar MECKI score. After propensity score, 77 patients treated with edoxaban were successfully matched with the MECKI-VKA control cohort. In both groups, MECKI accurately predicted the composite endpoint with similar area under the curves (AUC = 0.757 vs. 0.829 in the MECKI-VKA vs. edoxaban-treated group, respectively, p = 0.452). The two populations’ survival appeared non-significantly different at the 2-year follow-up. Conclusions: this study confirms the prognostic accuracy of the MECKI score in HFrEF patients with NVAF treated with edoxaban, showing improved predictive power compared to VKA-treated patients.
Keywords
- NVAF
- heart failure (HF)
- prognosis
- cardiopulmonary exercise testing (CPET)
- atrial fibrillation
- edoxaban