title: The MUSIC Risk score: a simple method for predicting mortality in ambulatory patients with chronic heart failure.
abstract: OBJECTIVE
  The prognosis of chronic heart failure (CHF) is extremely variable, although generally poor. The purpose of this study was to develop prognostic models for CHF patients.
  
  
  RESULTS
  A cohort of 992 consecutive ambulatory CHF patients was prospectively followed for a median of 44 months. Multivariable Cox models were developed to predict all-cause mortality (n = 267), cardiac mortality (primary end-point, n = 213), pump-failure death (n = 123), and sudden death (n = 90). The four final models included several combinations of the same 10 independent predictors: prior atherosclerotic vascular event, left atrial size >26 mm/m(2), ejection fraction < or =35%, atrial fibrillation, left bundle-branch block or intraventricular conduction delay, non-sustained ventricular tachycardia and frequent ventricular premature beats, estimated glomerular filtration rate <60 mL/min/1.73 m(2), hyponatremia < or =138 mEq/L, NT-proBNP >1.000 ng/L, and troponin-positive. On the basis of Cox models, the MUSIC Risk scores were calculated. A cardiac mortality score >20 points identified a high-risk subgroup with a four-fold cardiac mortality risk.
  
  
  CONCLUSIONS
  A simple score with a limited number of non-invasive variables successfully predicted cardiac mortality in a real-life cohort of CHF patients. The use of this model in clinical practice identifies a subgroup of high-risk patients that should be closely managed.
authors.affiliation: Cardiology Service, Valme University Hospital, Carretera a Cadiz s/n, 41014 Seville, Spain. plan@telefonica.net
authors.forename: Rafael
authors.initials: R
authors.lastname: Vazquez
authors.forename: Antoni
authors.initials: A
authors.lastname: Bayes-Genis
authors.forename: Iwona
authors.initials: I
authors.lastname: Cygankiewicz
authors.forename: Domingo
authors.initials: D
authors.lastname: Pascual-Figal
authors.forename: Lilian
authors.initials: L
authors.lastname: Grigorian-Shamagian
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pavon
authors.forename: Jose R
authors.initials: JR
authors.lastname: Gonzalez-Juanatey
authors.forename: José M
authors.initials: JM
authors.lastname: Cubero
authors.forename: Luis
authors.initials: L
authors.lastname: Pastor
authors.forename: Jordi
authors.initials: J
authors.lastname: Ordonez-Llanos
authors.forename: Juan
authors.initials: J
authors.lastname: Cinca
authors.forename: Antoni Bayes
authors.initials: AB
authors.lastname: de Luna
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002037:Bundle-Branch Block / Q000401:mortality*; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D055815:Young Adult