caa a22 4500 60622095X CHVBK 20210128101126.0 cr unu---uuuuu 210128e20150501xx s 000 0 eng 10.1007/s00380-014-0494-7 doi (NATIONALLICENCE)springer-10.1007/s00380-014-0494-7 A prognostic index for risk stratification for acute heart failure and death in subjects with ischemic cardiomyopathy and cardiac defibrillator [Elektronische Daten] [Lanfranco Antonini, Cristina Mollica, Antonio Auriti, Christian Pristipino, Vincenzo Pasceri, Francesca Leone, Salvatore Greco] To propose a clinical prognostic index for death and heart failure in patients with ischemic cardiomyopathy implanted with an ICD. This prospective study included 192 consecutive patients (age 68±10) recruited from 2004 to 2009 and implanted with an ICD for MADIT II criteria. All patients performed 24-h ambulatory blood pressure monitoring after discharge and common haematological samples. The prognostic index (PI) was built according to the formula: 120−age+mean 24h systolic blood pressure−(creatinine×10). Other variables were assessed: EF, haemoglobin concentration, mean 24h heart rate and diastolic blood pressure, sodium level, pacing mode and diabetes. Non-arrhythmic cardiac death and new hospitalizations for heart failure during 1-year follow-up were the combined end point. A total of 48 events (25%) occurred during the follow-up: 7 cardiac deaths and 41 hospitalizations for acute heart failure. Cox proportional-hazards model showed that PI was the only predictor of events (HR=0.96; CI 95% 0.944-0.976, p<0.0001). ROC curve showed that PI best cut-off was 144, with AUC 0.79, p<0.0001; sensitivity 77%, specificity 74%, positive predictive value 50%, negative predictive value 90%. PI was predictive of events in a clinical setting where EF had no predictive value. PI works according to the rule "the lower the worse”. The high negative predictive value (90%) of PI allows to identify subjects at lower risk for death and heart failure. PI can be a practical tool to stratify risk in ischemic cardiomyopathy. Springer Japan, 2014 Heart failure nationallicence Ambulatory blood pressure monitoring nationallicence Systolic dysfunction nationallicence Ischemic cardiomyopathy nationallicence Internal cardiac defibrillator nationallicence Antonini Lanfranco Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy aut Mollica Cristina Statistic Department, Probabilities and Applied Statistics, Sapienza University, Rome, Italy aut Auriti Antonio Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy aut Pristipino Christian Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy aut Pasceri Vincenzo Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy aut Leone Francesca Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy aut Greco Salvatore Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy aut Heart and Vessels Springer Japan 30/3(2015-05-01), 325-330 0910-8327 30:3<325 2015 30 380 https://doi.org/10.1007/s00380-014-0494-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00380-014-0494-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Antonini Lanfranco Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy aut NATIONALLICENCE 700 1- Mollica Cristina Statistic Department, Probabilities and Applied Statistics, Sapienza University, Rome, Italy aut NATIONALLICENCE 700 1- Auriti Antonio Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy aut NATIONALLICENCE 700 1- Pristipino Christian Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy aut NATIONALLICENCE 700 1- Pasceri Vincenzo Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy aut NATIONALLICENCE 700 1- Leone Francesca Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy aut NATIONALLICENCE 700 1- Greco Salvatore Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy aut NATIONALLICENCE 773 0- Heart and Vessels Springer Japan 30/3(2015-05-01), 325-330 0910-8327 30:3<325 2015 30 380