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Usefulness of the Vall d’Hebron Risk Score to stratify the risk of patients with ischemic cardiomyopathy

  • Original Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Background

To evaluate the Vall d’Hebron-Risk-Score (VH-RS) to stratify the risk of patients with stable ischemic cardiomyopathy (ICM), and assess whether hemoglobin (Hb) and estimated glomerular filtration rate (eGFR) provide additional information to the VH-RS.

Methods and results

We analysed 673 consecutive patients with ICM who underwent gated SPECT. According to VH-RS, we stratified patients into 4-risk-levels: very-low-risk (VLR), low-risk (LR), moderate-risk (MR), and high-risk (HRi). We considered as MACEs: non-fatal myocardial infarction (MI), heart failure hospitalization (HF), coronary revascularization (CR), and cardiac death (CD). Also the cardiac-resynchronization-therapy (CRT), and the implantable-cardioverter-defibrillator (ICD) were investigated. During the follow-up (4.8 ± 2.7 years), 379 patients had MACEs (0.18/patient/year). There were no patients in VLR and LR. All patients were reclassified in 3-risk-levels (MRi = 48; HRi = 121; VHRi[very high risk] = 504). Most patients with MACEs were in VHRi level (test-for-trend: MACEs ≥ 1 without CRT/ICD, P < .001; combined non-fatal MI, CD and CR, P < .001; MACEs ≥ 1 with CRT/ICD, P < .001). The Hb and eGFR values do not properly improve the risk stratification obtained by the VH-RS (global-NRI[net-reclassification-improvement] was: (MACEs ≥ 1 without CRT/ICD: − 10.6%; non-fatal MI, CD and CR: − 9.08%; and MACEs ≥ 1 with CRT/ICD: − 8.85%).

Conclusion

VH-RS is effective in evaluating risk of patients with stable ICM. In our population, adding Hb and eGFR variables do not improve the performance of the VH-RS.

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Abbreviations

CRT:

Cardiac-resynchronization-therapy

eGFR:

Estimated glomerular filtration rate

ICD:

Implantable-cardioverter-defibrillator

ICM:

Ischemic cardiomyopathy

LRi:

Low-risk

MACEs:

Major-adverse-cardiac-event

MRi:

Moderate-risk

NRI:

Net reclassification improvement

VH-RS:

Vall d’Hebron Risk-Score

VLRi:

Very-low-risk

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Acknowledgements

The authors are grateful to Rosemay Chehab (London) for her grammatical English correction.

Author information

Authors and Affiliations

  1. Nuclear Cardiology Department, Vall d’Hebron University Hospital, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain

    Guillermo Romero-Farina MD, PhD, FESC, FASNC, FEACVI & Santiago Aguadé-Bruix MD

  2. Centro de investigación biomédica en red: enfermedades cardiovasculares (CIBER-CV), Madrid, Spain

    Guillermo Romero-Farina MD, PhD, FESC, FASNC, FEACVI & Santiago Aguadé-Bruix MD

  3. Grup d’imatge mèdica molecular de l’VHIR (GRIMM), Barcelona, Spain

    Guillermo Romero-Farina MD, PhD, FESC, FASNC, FEACVI & Santiago Aguadé-Bruix MD

  4. Cardiology Department, Consorci Sanitari de l’Alt Penedès i Garraf (CSAPG), Barcelona, Spain

    Guillermo Romero-Farina MD, PhD, FESC, FASNC, FEACVI

  5. Cardiology Department, Vall d’Hebron University Hospital, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain

    Guillermo Romero-Farina MD, PhD, FESC, FASNC, FEACVI, Eduard Ródenas-Alesina MD, Lorena Herrador MD, Pablo Jordán MD & Ignacio Ferreira-González MD, PhD, FESC

  6. Centro de investigación biomédica en red: epidemiología y salud pública (CIBER-ESP), Madrid, Spain

    Ignacio Ferreira-González MD, PhD, FESC

  7. Nuclear Medicine Department and Cardiology Department, Hospital Universitari Vall d’Hebron, Paseo Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Guillermo Romero-Farina MD, PhD, FESC, FASNC, FEACVI

Authors
  1. Guillermo Romero-Farina MD, PhD, FESC, FASNC, FEACVI
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  2. Santiago Aguadé-Bruix MD
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  3. Eduard Ródenas-Alesina MD
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  6. Ignacio Ferreira-González MD, PhD, FESC
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Correspondence to Guillermo Romero-Farina MD, PhD, FESC, FASNC, FEACVI.

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Romero-Farina, G., Aguadé-Bruix, S., Ródenas-Alesina, E. et al. Usefulness of the Vall d’Hebron Risk Score to stratify the risk of patients with ischemic cardiomyopathy. J. Nucl. Cardiol. 30, 751–763 (2023). https://doi.org/10.1007/s12350-022-03074-6

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  • DOI: https://doi.org/10.1007/s12350-022-03074-6

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