PLoS ONE (Jan 2020)

Cardio-renal and cardio-hepatic interactions predict cardiovascular events in elderly patients with heart failure.

  • Takahiro Okano,
  • Hirohiko Motoki,
  • Masatoshi Minamisawa,
  • Kazuhiro Kimura,
  • Masafumi Kanai,
  • Koji Yoshie,
  • Satoko Higuchi,
  • Tatsuya Saigusa,
  • Soichiro Ebisawa,
  • Ayako Okada,
  • Morio Shoda,
  • Koichiro Kuwahara

DOI
https://doi.org/10.1371/journal.pone.0241003
Journal volume & issue
Vol. 15, no. 10
p. e0241003

Abstract

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BackgroundThe composite Model for End-Stage Liver Disease Excluding International Normalized Ratio Score (MELD-XI) is a novel tool to evaluate cardio-renal and cardio-hepatic interactions in patients with advanced heart failure (HF). However, its prognostic ability remains unclear in elderly HF patients.Methods and resultsFrom July 2014 to July 2018, patients hospitalized for HF were prospectively recruited at 16 centers. Clinical features, laboratory findings, and echocardiography results were assessed prior to discharge. Cardiovascular (CV) death and HF re-hospitalization were recorded. Of the 676 patients enrolled, 264 (39.1%) experienced CV events throughout a 1-year median follow-up period. Patients with high MELD-XI were predominantly male and had a higher prevalence of NYHA III/IV, history of HF admission, hyperuricemia, ventricular tachycardia, anemia, and ischemic heart disease. In Kaplan-Meyer analysis, patients with higher MELD-XI (≥11) scores showed a worse prognosis than did those with lower (ConclusionsCardio-renal and cardio-hepatic interactions predicted CV events in aged HF patients.