MMMELD-XI Score Is Associated With Short-Term Adverse Events in Patients With Heart Failure With Preserved Ejection Fraction

Sunying Wang; Yuwei Wang; Manqing Luo; Kaiyang Lin; Xiaoxu Xie; Na Lin; Qingyong Yang; Tian Zou; Xinan Chen; Xianwei Xie; Yansong Guo

doi:10.3389/fcvm.2021.650191

MMMELD-XI Score Is Associated With Short-Term Adverse Events in Patients With Heart Failure With Preserved Ejection Fraction

Front Cardiovasc Med. 2021 May 25:8:650191. doi: 10.3389/fcvm.2021.650191. eCollection 2021.

Authors

Sunying Wang¹, Yuwei Wang¹, Manqing Luo¹, Kaiyang Lin¹, Xiaoxu Xie¹, Na Lin¹, Qingyong Yang¹, Tian Zou¹, Xinan Chen¹, Xianwei Xie¹, Yansong Guo¹

Affiliation

¹ Department of Cardiology, Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China.

Abstract

Aim: Accumulating evidence suggests that MELD-XI score holds the ability to predict the prognosis of congestive heart failure. However, most of the evidence is based on the end-stage heart failure population; thus, we aim to explore the association between the MELD-XI score and the prognosis in heart failure with preserved ejection fraction (HFpEF). Methods: A total of 30,096 patients hospitalized for HFpEF in Fujian Provincial Hospital between January 1, 2014 and July 17, 2020 with available measures of creatinine and liver function were enrolled. The primary endpoint was 60-day in-hospital all-cause mortality. Secondary endpoints were 60-day in-hospital cardiovascular mortality and 30-day rehospitalization for heart failure. Results: A total of 222 patients died within 60 days after admission, among which 75 deaths were considered cardiogenic. And 73 patients were readmitted for heart failure within 30 days after discharge. Generally, patients with an elevated MELD-XI score tended to have more comorbidities, higher NYHA class, and higher inflammatory biomarkers levels. Meanwhile, the MELD-XI score was positively correlated with NT-pro BNP, left atrial diameter, E/e' and negatively correlated with LVEF. After adjusting for conventional risk factors, the MELD-XI score was independently associated with 60-day in-hospital all-cause mortality [hazard ratio(HR) = 1.052, 95% confidential interval (CI) 1.022-1.083, P = 0.001], 60-day in-hospital cardiovascular mortality (HR = 1.064, 95% CI 1.013-1.118, P = 0.014), and 30-day readmission for heart failure (HR = 1.061, 95% CI 1.015-1.108, P = 0.009). Furthermore, the MELD-XI score added an incremental discriminatory capacity to risk stratification models developed based on this cohort. Conclusion: The MELD-XI score was associated with short-term adverse events and provided additional discriminatory capacity to risk stratification models in patients hospitalized for HFpEF.

Keywords: MELD-XI score; heart failure with preserved ejection fraction; prognosis; risk stratification; short-term.