Abstract 10001: The Systemic Inflammation-Based Glasgow Prognostic Score Predicts Prognosis in Acute Decompensated Heart Failure Patients with Preserved Left Ventricular Ejection Fraction: A Multicenter Study

Abstract

Background: A systemic inflammatory state caused by comorbidities has been shown to play a key role in pathophysiology of heart failure with preserved ejection fraction (HFpEF). The inflammation-based prognostic score termed Glasgow prognostic score (GPS), combining C-reactive protein and albumin, has been reported to provide prognostic information in patients with cancer or heart failure. However, little is known about the usefulness of the GPS for the prediction of prognosis in patients with HFpEF who are admitted with acute decompensated heart failure (ADHF). Methods: Patients' data were extracted from The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT-HFpEF) study, which is a prospective multicenter observational registry for ADHF patients with LVEF ≥50% in Osaka area. We studied 1017 patients who survived to discharge. The GSP was calculated at discharge as follows: patients with both elevated C-reactive protein (>1.0mg/dL) and hypoalbuminemia (<3.5g/dL) were allocated a score of 2, patients with one of these abnormalities were allocated a score of 1, and patients with neither of these were allocated a score of 0. The endpoint was all-cause death. Results: During a follow-up period of 1.5±1.2 years, 178 patients had all-cause death. At multivariate Cox analysis, GPS 1 (hazard ratio [HR] 1.71, 95% confidence interval [CI] 1.14-2.56, p=0.0090) and GPS 2 (HR 2.42, 95% CI 1.51-3.88, p=0.0003) were independently associated with all-cause death after the adjustment for major confounders. There was significant difference in the rate of all-cause death when the patients were stratified according to the GPS (Figure). Conclusions: In this multicenter study, the systemic inflammation-based GPS was shown to be useful for the prediction of prognosis in HFpEF patients admitted for ADHF.