Abstract 12205: Prediction of Heart Failure Symptoms Using Framingham and ARIC Scores in Patients With Non Ischemic Risk Factors at 1 Year Follow up

Abstract

Background: The Framingham heart failure score (FHS) and ARIC heart failure (HF) risk calculator are risk prediction tools that might facilitate the targeting of prevention strategies in pts with HF risk factors. We sought to compare their performance of predicting new HF symptoms in pts with risk factors. Method: Subjects ≥65 yo, with ≥ 1 HF risk (hypertension, type 2 diabetes, obesity, previous chemotherapy, family history of HF or previous cardiac history) were recruited from the local community. Absolute risk of incident HF risk was calculated using ARIC and FHS risk scores at baseline. Subjects underwent standard questionnaire, electrocardiogram, comprehensive echocardiogram and 6-minute walk (6MW) test. New HF based on Framingham criteria were assessed after a follow-up of 14±4 months. Results: Among 308 subjects (age 71±5 y; 50% men), median (IQR) 4 year risk of FHS and ARIC score were 4.0 (2-6.5) % and 6.2 (3.6-11.4) %, respectively. 19 participants developed new HF signs and symptoms (Framingham criteria). Compared with those remaining asymptomatic, those with new HF had higher ARIC score (p<0.001), more impaired GLS (p=0.036), larger left atrium volume (p=0.05) and left ventricular (LV) mass (p=0.049. They also had significant baseline 6MW test distance (p=0.003). There was no difference between their FHS score (p=0.325) and other conventional diastolic measures including LV ejection fraction, mitral E/A, e’ and E/e’ (p=0.108-0.804). AUC of ARIC and FHS were 0.74 (p=0.001) and 0.63 (p=0.057), respectively. The AUC of 6MW was 0.698 (p=0.005) (figure). Conclusion: The ARIC score appears to be more predictive than FHS score in prediction of new HF symptoms in non-ischemic stage A HF. 6MW test maybe used as an effective screening tool in community based process.