Prognostic value of the model for end-stage liver disease excluding INR score (MELD-XI) in patients with adult congenital heart disease
Autoři:
Ryo Konno aff001; Shunsuke Tatebe aff001; Koichiro Sugimura aff001; Kimio Satoh aff001; Tatsuo Aoki aff001; Masanobu Miura aff001; Hideaki Suzuki aff001; Saori Yamamoto aff001; Haruka Sato aff001; Yosuke Terui aff001; Satoshi Miyata aff002; Osamu Adachi aff003; Masato Kimura aff004; Yoshikatsu Saiki aff003; Hiroaki Shimokawa aff001
Působiště autorů:
Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
aff001; Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
aff002; Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
aff003; Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Japan
aff004
Vyšlo v časopise:
PLoS ONE 14(11)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0225403
Souhrn
Patients with adult congenital heart disease (ACHD) are at increased risk of developing late cardiovascular complication. However, little is known about the predictive factors for long-term outcome. The Model for End-Stage Liver Disease eXcluding INR (MELD-XI) score was originally developed to assess cirrhotic patients and has the prognostic value for heart failure (HF) patients. In the present study, we examined whether the score also has the prognostic value in this population. We retrospectively examined 637 ACHD patients (mean age 31.0 years) who visited our Tohoku University hospital from 1995 to 2015. MELD-XI score was calculated as follows; 11.76 x ln(serum creatinine) + 5.11 x ln(serum total bilirubin) + 9.44. We compared the long-term outcomes between the high (≥10.4) and the low (<10.4) score groups. The cutoff value of MELD-XI score was determined based on the survival classification and regression tree (CART) analysis. The major adverse cardiac event (MACE) was defined as a composite of cardiac death, HF hospitalization, and lethal ventricular arrhythmias. During a mean follow-up period of 8.6 years (interquartile range 4.4–11.4 years), MACE was noted in 51 patients, including HF hospitalization in 37, cardiac death in 8, and lethal ventricular arrhythmias in 6. In Kaplan-Meier analysis, the high score group had significantly worse MACE-free survival compared with the low score group (log-rank, P<0.001). Multivariable Cox regression analysis showed that the MELD-XI score remained a significant predictor of MACE (hazard ratio 1.36, confidence interval 1.17–1.58, P<0.001) even after adjusting for patient characteristics, such as sex, functional status, estimated glomerular filtration rate, and cardiac function. Furthermore, CART analysis revealed that the MELD-XI score was the most important variable for predicting MACE. These results demonstrate that the MELD-XI score can effectively predict MACE in ACHD patients, indicating that ACHD patients with high MELD-XI score need to be closely followed.
Klíčová slova:
bilirubin – Liver diseases – Creatinine – Heart failure – Pulmonary hypertension – Congenital heart defects – Fontan operation – Valvular diseases
Zdroje
1. Moons P, Bovijn L, Budts W, Belmans A, Gewillig M. Temporal trends in survival to adulthood among patients born with congenital heart disease from 1970 to 1992 in Belgium. Circulation. 2010; 122(22):2264–2272. doi: 10.1161/CIRCULATIONAHA.110.946343 21098444
2. Mulder BJM. Epidemiology of adult congenital heart disease: demographic variations worldwide. Neth Heart J. 2012; 20(12):505–508. doi: 10.1007/s12471-012-0335-1 23225563
3. Verheugt CL, Uiterwaal CS, van der Velde ET, Meijboom FJ, Pieper PG, van Dijk AP, et al. Mortality in adult congenital heart disease. Eur Heart J. 2010; 31(10):1220–1229. doi: 10.1093/eurheartj/ehq032 20207625
4. Diller GP, Kempny A, Alonso-Gonzalez R, Swan L, Uebing A, Li W, et al. Survival Prospects and Circumstances of Death in Contemporary Adult Congenital Heart Disease Patients Under Follow-Up at a Large Tertiary Centre. Circulation. 2015; 132(22):2118–2125. doi: 10.1161/CIRCULATIONAHA.115.017202 26369353
5. Engelings CC, Helm PC, Abdul-Khaliq H, Asfour B, Bauer UM, Baumgartner H, et al. Cause of death in adults with congenital heart disease—An analysis of the German National Register for Congenital Heart Defects. Int J Cardiol. 2016; 211:31–36. doi: 10.1016/j.ijcard.2016.02.133 26970963
6. Naidu P, Grigg L, Zentner D. Mortality in adults with congenital heart disease. Int J Cardiol. 2017; 245:125–130. doi: 10.1016/j.ijcard.2017.05.132 28874283
7. Konno R, Tatebe S, Sugimura K, Satoh K, Aoki T, Miura M, et al. Effects of Hepatitis C Virus Antibody-Positivity on Cardiac Function and Long-Term Prognosis in Patients With Adult Congenital Heart Disease. Am J Cardiol. 2018; 122(11):1965–1971. doi: 10.1016/j.amjcard.2018.08.045 30442226
8. Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology. 2000; 31(4):864–871. doi: 10.1053/he.2000.5852 10733541
9. Szygula-Jurkiewicz B, Zakliczynski M, Andrejczuk M, Moscinski M, Zembala M. The Model for End-Stage Liver Disease (MELD) can predict outcomes in ambulatory patients with advanced heart failure who have been referred for cardiac transplantation evaluation. Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery. 2014; 11(2):178–181. doi: 10.5114/kitp.2014.43847 26336418
10. Heuman DM, Mihas AA, Habib A, Gilles HS, Stravitz RT, Sanyal AJ, et al. MELD-XI: a rational approach to "sickest first" liver transplantation in cirrhotic patients requiring anticoagulant therapy. Liver Transpl. 2007; 13(1):30–37. doi: 10.1002/lt.20906 17154400
11. Abe S, Yoshihisa A, Takiguchi M, Shimizu T, Nakamura Y, Yamauchi H, et al. Liver dysfunction assessed by model for end-stage liver disease excluding INR (MELD-XI) scoring system predicts adverse prognosis in heart failure. PLoS One. 2014; 9(6):e100618. doi: 10.1371/journal.pone.0100618 24955578
12. Inohara T, Kohsaka S, Shiraishi Y, Goda A, Sawano M, Yagawa M, et al. Prognostic impact of renal and hepatic dysfunction based on the MELD-XI score in patients with acute heart failure. Int J Cardiol. 2014; 176(3):571–573. doi: 10.1016/j.ijcard.2014.08.052 25305701
13. Biegus J, Zymlinski R, Sokolski M, Siwolowski P, Gajewski P, Nawrocka-Millward S, et al. Impaired hepato-renal function defined by the MELD XI score as prognosticator in acute heart failure. Eur J Heart Fail. 2016; 18(12):1518–1521. doi: 10.1002/ejhf.644 27709804
14. Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009; 53(6):982–992. doi: 10.1053/j.ajkd.2008.12.034 19339088
15. Warnes CA, Liberthson R, Danielson GK, Dore A, Harris L, Hoffman JI, et al. Task force 1: the changing profile of congenital heart disease in adult life. J Am Coll Cardiol. 2001; 37(5):1170–1175. doi: 10.1016/s0735-1097(01)01272-4 11300418
16. Lemon SC, Roy J, Clark MA, Friedmann PD, Rakowski W. Classification and regression tree analysis in public health: methodological review and comparison with logistic regression. Ann Behav Med. 2003; 26(3):172–181. doi: 10.1207/S15324796ABM2603_02 14644693
17. van Deursen VM, Damman K, van der Meer P, Wijkstra PJ, Luijckx GJ, van Beek A, et al. Co-morbidities in heart failure. Heart Fail Rev. 2014; 19(2):163–172. doi: 10.1007/s10741-012-9370-7 23266884
18. Allen LA, Felker GM, Pocock S, McMurray JJ, Pfeffer MA, Swedberg K, et al. Liver function abnormalities and outcome in patients with chronic heart failure: data from the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) program. Eur J Heart Fail. 2009; 11(2):170–177. doi: 10.1093/eurjhf/hfn031 19168515
19. Hillege HL, Girbes AR, de Kam PJ, Boomsma F, de Zeeuw D, Charlesworth A, et al. Renal function, neurohormonal activation, and survival in patients with chronic heart failure. Circulation. 2000; 102(2):203–210. doi: 10.1161/01.cir.102.2.203 10889132
20. Price S, Jaggar SI, Jordan S, Trenfield S, Khan M, Sethia B, et al. Adult congenital heart disease: intensive care management and outcome prediction. Intensive Care Med. 2007; 33(4):652–659. doi: 10.1007/s00134-007-0544-z 17333117
21. Dimopoulos K, Diller GP, Koltsida E, Pijuan-Domenech A, Papadopoulou SA, Babu-Narayan SV, et al. Prevalence, predictors, and prognostic value of renal dysfunction in adults with congenital heart disease. Circulation. 2008; 117(18):2320–2328. doi: 10.1161/CIRCULATIONAHA.107.734921 18443238
22. Matthews JC, Pagani FD, Haft JW, Koelling TM, Naftel DC, Aaronson KD. Model for end-stage liver disease score predicts left ventricular assist device operative transfusion requirements, morbidity, and mortality. Circulation. 2010; 121(2):214–220. doi: 10.1161/CIRCULATIONAHA.108.838656 20048215
23. Chokshi A, Cheema FH, Schaefle KJ, Jiang J, Collado E, Shahzad K, et al. Hepatic dysfunction and survival after orthotopic heart transplantation: application of the MELD scoring system for outcome prediction. J Heart Lung Transplant. 2012; 31(6):591–600. doi: 10.1016/j.healun.2012.02.008 22458996
24. Kim MS, Kato TS, Farr M, Wu C, Givens RC, Collado E, et al. Hepatic dysfunction in ambulatory patients with heart failure: application of the MELD scoring system for outcome prediction. J Am Coll Cardiol. 2013; 61(22):2253–2261. doi: 10.1016/j.jacc.2012.12.056 23563127
25. De Caterina R, Husted S, Wallentin L, Andreotti F, Arnesen H, Bachmann F, et al. Vitamin K antagonists in heart disease: current status and perspectives (Section III). Position paper of the ESC Working Group on Thrombosis—Task Force on Anticoagulants in Heart Disease. Thromb Haemost. 2013; 110(6):1087–1107. doi: 10.1160/TH13-06-0443 24226379
26. Wan D, Tsui C, Kiess M, Grewal J, Krahn AD, Chakrabarti S. Anticoagulation for Thromboembolic Risk Reduction in Adults With Congenital Heart Disease. Can J Cardiol. 2017; 33(12):1597–1603. doi: 10.1016/j.cjca.2017.08.009 29066332
27. Assenza GE, Graham DA, Landzberg MJ, Valente AM, Singh MN, Bashir A, et al. MELD-XI score and cardiac mortality or transplantation in patients after Fontan surgery. Heart. 2013; 99(7):491–496. doi: 10.1136/heartjnl-2012-303347 23406689
28. Lewis M, Ginns J, Schulze C, Lippel M, Chai P, Bacha E, et al. Outcomes of Adult Patients With Congenital Heart Disease After Heart Transplantation: Impact of Disease Type, Previous Thoracic Surgeries, and Bystander Organ Dysfunction. J Card Fail. 2016; 22(7):578–582. doi: 10.1016/j.cardfail.2015.09.002 26432646
29. Adams ED, Jackson NJ, Young T, DePasquale EC, Reardon LC. Prognostic utility of MELD-XI in adult congenital heart disease patients undergoing cardiac transplantation. Clin Transplant. 2018; 32(6):e13257. doi: 10.1111/ctr.13257 29660764
30. Giannico S, Hammad F, Amodeo A, Michielon G, Drago F, Turchetta A, et al. Clinical outcome of 193 extracardiac Fontan patients: the first 15 years. J Am Coll Cardiol. 2006; 47(10):2065–2073. doi: 10.1016/j.jacc.2005.12.065 16697327
31. Khairy P, Fernandes SM, Mayer JE Jr., Triedman JK, Walsh EP, Lock JE, et al. Long-term survival, modes of death, and predictors of mortality in patients with Fontan surgery. Circulation. 2008; 117(1):85–92. doi: 10.1161/CIRCULATIONAHA.107.738559 18071068
Článok vyšiel v časopise
PLOS One
2019 Číslo 11
- Metamizol jako analgetikum první volby: kdy, pro koho, jak a proč?
- Nejasný stín na plicích – kazuistika
- Masturbační chování žen v ČR − dotazníková studie
- Úspěšná resuscitativní thorakotomie v přednemocniční neodkladné péči
- Dlouhodobá recidiva a komplikace spojené s elektivní operací břišní kýly
Najčítanejšie v tomto čísle
- A daily diary study on maladaptive daydreaming, mind wandering, and sleep disturbances: Examining within-person and between-persons relations
- A 3’ UTR SNP rs885863, a cis-eQTL for the circadian gene VIPR2 and lincRNA 689, is associated with opioid addiction
- A substitution mutation in a conserved domain of mammalian acetate-dependent acetyl CoA synthetase 2 results in destabilized protein and impaired HIF-2 signaling
- Molecular validation of clinical Pantoea isolates identified by MALDI-TOF