The Barcelona Bio-Heart Failure Risk Calculator may predict one-year mortality in patients with advanced heart failure.

Abstract

A combination of biochemical and clinical variables with new biomarkers is evaluated for the potential to improve the management of patients with heart failure (HF). This study assessed the predictive utility of a new prognostic scale, the Barcelona Bio-Heart Failure Risk Score (BCN), as well as traditional scores, the Heart Failure Survival Score (HFSS) and the Seattle Heart Failure Model (SHFM), in patients with end-stage HF. We also investigated the other risk factors associated with worse prognosis in the analyzed population. We performed a prospective analysis of 279 patients with end-stage HF listed for heart transplantation between 2018 and 2021. Their BCN, HFSS and SHFM were calculated. Human suppression of tumorigenicity 2 (ST2) was measured with a commercially available kit (Human ST-2 ELISA, SunRedBio Technology Co., Ltd., Shanghai, China). The median age of the patients was 56.0 (50.0-60.0) years, and 87.1% were male. During the one-year follow-up, 95 (34.1%) patients died. The areas under ROC associated with one-year mortality were as follows: 0.9466 [95% CI: 0.9194-0.9737] for BCN, 0.8092 [0.7606-0.8578] for HFSS, and 0.6967 [0.6349-0.7585] for SHFM. BCN (HR = 0.985 [0.981-0.988], P <0.001), HFSS (HR = 0.357 [0.236-0.541], P <0.001] and circulating bilirubin concentration (HR = 1.015 [1.002-1.028], P = 0.02) were associated with one-year mortality in the analyzed population. The BCN risk score had significantly better prognostic performance than HFSS or SHFM. Lower BCN and HFSS scores and higher bilirubin are independently associated with ahigher risk of one-year death in patients with end-stage HF.