ISSN 2149-2263 | E-ISSN 2149-2271
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Volume : 25 Issue : 6 Year : 2021
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The Age, Creatinine clearance and Ejection Fraction (mACEF) score predicts long-term cardiac mortality of patients with hypertrophic obstructive cardiomyopathy treated non-invasively [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-50322

The Age, Creatinine clearance and Ejection Fraction (mACEF) score predicts long-term cardiac mortality of patients with hypertrophic obstructive cardiomyopathy treated non-invasively

Jun Gao1, Chunli Shao2, Wenyao Wang2, Xiangbin Meng3, Kuo Zhang2, Jingjia Wang2, Mingqi Zheng1, Yi-Da Tang4
1Heart Center, The First Hospital of Hebei Medical University.
2Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
3Central China Fuwai hospital; Central China Branch of the National Cardiovascular Center; Department of Cardiology, Zhengzhou University People
4Department of Cardiology, Peking University Third Hospital; Beijing, China.

Background: Presently, effective model to predict long-term cardiac mortality in hypertrophic obstructive cardiomyopathy (HOCM) patients is lacking.
Objective: To evaluate predictive value of the modified Age, Creatinine clearance, and Ejection Fraction (mACEF) score for long-term cardiac mortality in HOCM.
Methods: Total 292 patients with HOCM treated non-invasively were enrolled in this study, all of whom with intact medical information.
Results: Over a median follow-up of 41.9 months, 28 cardiac deaths had occurred. In univariate Cox regression analysis, mACEF score was associated with long-term cardiac death (HR=1.795, 95%CI 1.518-2.124, p<0. 001). Multiple Cox regression analysis identified the mACEF score as an independent risk factor of long-term cardiac death (adjusted HR=1.372, 95%CI 1.076-1.749, p=0.011). Analysis of the receiver operating characteristic for long-term cardiac death showed that the mACEF score had a considerable predictive value (AUROC 0.844; sensitivity: 89.29%; specificity: 75.00%) with an optimum cut-off value of 0.96. The total study population was divided into high-risk (mACEF score ≥0.96, n=91) and low-risk (mACEF score<0.96, n=201) groups according to the optimum cut-off value. Kaplan-Meier survival analysis was performed and showed a dramatic higher rate of long-term cardiac mortality in the high-risk group when compared with the low-risk group (27.4% vs. 1.7%,p<0.001 by log-rank test).
Conclusions: The mACEF score has a considerable predictive value for long-term cardiac mortality in HOCM patients treated non-invasively. A mACEF score ≥0.96 could be considered as a sign of poor prognosis in patients with HOCM.

Keywords: hypertrophic obstructive cardiomyopathy, modified age, creatinine and ejection fraction score, cardiac mortality, risk stratification



Corresponding Author: Yi-Da Tang, China