title: Application of the Seattle Heart Failure Model in patients on cardiac resynchronization therapy.
abstract: BACKGROUND
  The Seattle Heart Failure Model (SHFM) is a multimarker risk assessment tool able to predict outcome in heart failure (HF) patients.
  
  
  OBJECTIVE
  To assess whether the SHFM can be used to risk-stratify HF patients who underwent cardiac resynchronization therapy with (CRT-D) or without (CRT) an implantable defibrillator.
  
  
  RESULTS
  The SHFM was applied to 342 New York Heart Association class III-IV patients who received a CRT (23%) or CRT-D (77%) device. Discrimination and calibration of SHFM were evaluated through c-statistics and Hosmer-Lemeshow (H-L) goodness-of-fit test. Primary endpoint was a composite of death from any cause/cardiac transplantation. During a median follow-up of 24 months (25th-75th percentile [pct]: 12-37 months), 78 of 342 (22.8%) patients died; seven patients underwent urgent transplantation. Median SHFM score for patients with endpoint was 5.8 years (25th-75th pct: 4.25-8.7 years) versus 8.9 years (25th-75th pct: 6.6-11.8 years) for those without (P < 0.001). Discrimination of SHFM was adequate for the endpoint (c-statistic always ranged around 0.7). The SHFM was a good fit of death from any cause/cardiac transplantation, without significant differences between observed and SHFM-predicted survival.
  
  
  CONCLUSIONS
  The SHFM successfully stratifies HF patients on CRT/CRT-D and can be reliably applied to help clinicians in predicting survival in this clinical setting.
authors: University of Florence, Florence, Italy. laura_perrotta81@hotmail.com
authors: Laura
authors: L
authors: Perrotta
authors: Giuseppe
authors: G
authors: Ricciardi
authors: Paolo
authors: P
authors: Pieragnoli
authors: Marco
authors: M
authors: Chiostri
authors: Giulia
authors: G
authors: Pontecorboli
authors: Tiziana
authors: T
authors: De Santo
authors: Fulvio
authors: F
authors: Bellocci
authors: Nicola
authors: N
authors: Vitulano
authors: Michele
authors: M
authors: Emdin
authors: Giosuè
authors: G
authors: Mascioli
authors: Ilaria
authors: I
authors: Ricceri
authors: Maria Cristina
authors: MC
authors: Porciani
authors: Antonio
authors: A
authors: Michelucci
authors: Luigi
authors: L
authors: Padeletti
mesh_terms: D000368:Aged; D058406:Cardiac Resynchronization Therapy / Q000401:mortality*; D005260:Female; D006333:Heart Failure / Q000401:mortality* / Q000517:prevention & control*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate