Heart Failure Model Accurately Predicts Patient Survival

Martha Kerr

March 21, 2006

March 21, 2006 (Atlanta) — The first computer-based model to translate medications and devices that a heart failure patient receives into predicted years of survival has been developed at the University of Washington, Seattle. The model was described here at the 55th annual scientific session of the American College of Cardiology, and a report on the model is published in the March 21 issue of Circulation.

The Seattle Heart Failure Model was developed by Wayne C. Levy, MD, associate professor of medicine in the Division of Cardiology, and colleagues at the University of Washington. He described the Web-based program for attendees at the meeting.

Medications prescribed and devices used by a patient with heart failure are plugged into the model, along with simple clinical and laboratory findings. Dr. Levy said the Seattle Heart Failure Model accurately predicts 1-, 2- and 3-year survival rates.

The Seattle team used a total of 6 databases, involving 9942 patients with heart failure, to develop the Web-based or Palm Pilot–based program. The physician enters the type of medications the patient is on, whether the patient has received an implantable cardioverter defibrillator (ICD), as well as the results of a number of simple clinical findings and widely available laboratory test results.

The program "allows easy and rapid calculation of the projected mortality at baseline and after interventions for patients with congestive heart failure," the investigators reported.

"It determines if you are on appropriate medications or devices," Dr. Levy told Medscape. "For example, you can calculate the benefit of adding an angiotensin-converting enzyme (ACE) inhibitor to beta-blocker therapy, or adding an angiotensin receptor-blocker to beta-blockers and ACE inhibitors."

Dr. Levy added, "It changes survival figures from percentages to the number of years lived longer. This makes it easier for patients and physicians to appreciate."

Dr. Levy said the model might be able to be used to assess risk of death, and to determine if risk increases exponentially toward the end of life. The model may also be useful in predicting the number of hospitalizations and number of days in the hospital per year.

"We didn't look specifically at quality of life with the model, but almost everything that improves survival, with the exception of the ICD, improves quality of life," the Seattle cardiologist said.

"We're determining if the model can be used as the control group in future studies of heart failure treatments, replacing the placebo group," Dr. Levy added. The model can be accessed at https://www.seattleheartfailuremodel.org.

Gerald Fletcher, MD, from the Division of Cardiology at the Mayo Clinic in Jacksonville, Florida, commented in an interview with Medscape that "there are 4 or 5 drugs that really affect heart failure survival.... However, what is not included in this model is exercise. We really believe that regular exercise will make a difference [in heart failure survival].... This is an intervention that has no cost."

Dr. Fletcher noted that "most heart failure patients can exercise, even with ejection fractions as low as 16%."

ACC 55th Annual Scientific Session: Abstract 1012-152. Presented March 14, 2006.

Reviewed by Ariana Del Negro