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. 2016 Jan 15:203:1067-72.
doi: 10.1016/j.ijcard.2015.11.075. Epub 2015 Nov 10.

The metabolic exercise test data combined with Cardiac And Kidney Indexes (MECKI) score and prognosis in heart failure. A validation study

Ugo Corrà  1 , Piergiuseppe Agostoni  2 , Andrea Giordano  3 , Gaia Cattadori  4 , Elisa Battaia  5 , Rocco La Gioia  6 , Angela B Scardovi  7 , Michele Emdin  8 , Marco Metra  9 , Gianfranco Sinagra  10 , Giuseppe Limongelli  11 , Rosa Raimondo  12 , Federica Re  13 , Marco Guazzi  14 , Romualdo Belardinelli  15 , Gianfranco Parati  16 , Damiano Magrì  17 , Cesare Fiorentini  2 , Mariantonietta Cicoira  18 , Elisabetta Salvioni  4 , Marta Giovannardi  4 , Fabrizio Veglia  4 , Alessandro Mezzani  19 , Domenico Scrutinio  6 , Andrea Di Lenarda  20 , Roberto Ricci  7 , Anna Apostolo  4 , Anna Maria Iorio  11 , Stefania Paolillo  21 , Pietro Palermo  4 , Mauro Contini  4 , Corrado Vassanelli  18 , Claudio Passino  22 , Pantaleo Giannuzzi  19 , Massimo F Piepoli  23 ; MECKI Score Research Group; Other Members of the MECKI Score research Group; Laura Antonioli  4 , Chiara Segurini  4 , Erica Bertella  4 , Stefania Farina  4 , Francesca Bovis  4 , Francesca Pietrucci  15 , Gabriella Malfatto  24 , Teo Roselli  25 , Andrea Buono  25 , Raffaele Calabrò  25 , Renata De Maria  26 , Daniela Santoro  27 , Saba Campanale  27 , Domenica Caputo  27 , Donatella Bertipaglia  28 , Emanuela Berton  29
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Free article

The metabolic exercise test data combined with Cardiac And Kidney Indexes (MECKI) score and prognosis in heart failure. A validation study

Ugo Corrà et al. Int J Cardiol. .
Free article

Abstract

Background: The Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score is a prognostic model to identify heart failure (HF) patients at risk for cardiovascular mortality (CVM) and urgent heart transplantation (uHT) based on 6 routine clinical parameters: hemoglobin, sodium, kidney function by the Modification of Diet in Renal Disease (MDRD) equation, left ventricle ejection fraction (LVEF), percentage of predicted peak oxygen consumption (VO2) and VE/VCO2 slope.

Objectives: MECKI score must be generalizable to be considered useful: therefore, its performance was validated in a new sequence of HF patients.

Methods: Both the development (MECKI-D) and the validation (MECKI-V) cohorts were composed of consecutive HF patients with LVEF <40% able to perform a symptom-limited cardiopulmonary exercise testing. The CVM or uHT rates were analyzed at one, two and three years in both cohorts: all patients with a censoring time shorter than the scheduled follow-up were excluded, while those with events occurring after 1, 2 and 3 years were considered as censored.

Results: MECKI-D and MECKI-V consisted of 2009 and 992 patients, respectively. MECKI-V patients had a higher LVEF, higher peak VO2 and lower VE/VCO2 slope, higher prescription of beta-blockers and device therapy: after the 3-year follow-up, CVM or uHT occurred in 206 (18%) MECKI-D and 44 (13%) MECKI-V patients (p<0.000), respectively. MECKI-V AUC values at one, two and three years were 0.81 ± 0.04, 0.76 ± 0.04, and 0.80 ± 0.03, respectively, not significantly different from MECKI-D.

Conclusions: MECKI score preserves its predictive ability in a HF population at a lower risk.

Keywords: Heart failure; Prognosis, score.

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