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Eur Heart J. 2009 May;30(9):1088-96. doi: 10.1093/eurheartj/ehp032. Epub 2009 Feb 24.

The MUSIC Risk score: a simple method for predicting mortality in ambulatory patients with chronic heart failure.

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1
Cardiology Service, Valme University Hospital, Carretera a Cadiz s/n, 41014 Seville, Spain. plan@telefonica.net

Abstract

AIMS:

The prognosis of chronic heart failure (CHF) is extremely variable, although generally poor. The purpose of this study was to develop prognostic models for CHF patients.

METHODS AND RESULTS:

A cohort of 992 consecutive ambulatory CHF patients was prospectively followed for a median of 44 months. Multivariable Cox models were developed to predict all-cause mortality (n = 267), cardiac mortality (primary end-point, n = 213), pump-failure death (n = 123), and sudden death (n = 90). The four final models included several combinations of the same 10 independent predictors: prior atherosclerotic vascular event, left atrial size >26 mm/m(2), ejection fraction < or =35%, atrial fibrillation, left bundle-branch block or intraventricular conduction delay, non-sustained ventricular tachycardia and frequent ventricular premature beats, estimated glomerular filtration rate <60 mL/min/1.73 m(2), hyponatremia < or =138 mEq/L, NT-proBNP >1.000 ng/L, and troponin-positive. On the basis of Cox models, the MUSIC Risk scores were calculated. A cardiac mortality score >20 points identified a high-risk subgroup with a four-fold cardiac mortality risk.

CONCLUSION:

A simple score with a limited number of non-invasive variables successfully predicted cardiac mortality in a real-life cohort of CHF patients. The use of this model in clinical practice identifies a subgroup of high-risk patients that should be closely managed.

PMID:
19240065
DOI:
10.1093/eurheartj/ehp032
[Indexed for MEDLINE]
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