Predictive value of the age-adjusted charlson comorbidity index for cardiogenic death in patients with heart failure with reduced ejection fraction
ZHAO Chun-xiu
ZHANG Xue-he
SUN Hua-xin
WANG Zhong
WANG Han-xiao
KANG Sheng-nan
ZHANG Tong
ZHANG Chuan
Abstract：Objective To investigate the predictive value of the Age-Adjusted Charlson Comorbidity Index(ACCI)for long-term adverse prognosis in patients with heart failure with reduced ejection fraction(HFrEF).Methods The patients diagnosed with HFrEF[left ventricular ejection fraction(LVEF)≤40%]at the Third People's Hospital of Chengdu from January 2018 to June 2023 were enrolled.The baseline clinical data were collected and ACCI scores were calculated.The follow-up was conducted for 12 months via outpatient and inpatient electronic medical records and telephone interviews.The primary endpoint was cardiac death.The survival analysis was performed using the Kaplan-Meier method,and multivariate Cox regression was employed to assess the relationship between ACCI and cardiac death in HFrEF patients.The predictive performance of ACCI for cardiac death was evaluated using the area under the curve(AUC).Results A total of 1,662 patients were included and divided into the high-score group(888 cases,ACCI≥6)and the low-score group(774 cases,ACCI<6)based on the median ACCI value of 6.Kaplan-Meier analysis revealed significantly lower survival in the high-score group(Log-rank P<0.001).Multivariate Cox regression analysis indicated that ACCI(as a continuous variable:HR=1.273,95%CI 1.185-1.367,P<0.001)and ACCI≥6(as a categorical variable:HR=1.775,95%CI 1.378-2.285,P<0.001)were independently associated with prognosis in HFrEF patients even after adjusting for potential confounders.Furthermore,ACCI demonstrated a certain predictive value for cardiac death(AUC=0.647,95%CI 0.614-0.681).Conclusion ACCI can serve as an effective tool for assessing the risk of cardiac death in HFrEF patients,aiding in the identification of high-risk populations and providing a basis for clinical stratification management.
Keywords：Heart failure with reduced ejection fractionAge-adjusted Charlson Comorbidity IndexCardiac deathPrognostic assessment
Publication Date：2025-09-20
Online Publishing Date：2025-09-30(First online date of this platform, not the publication date of the document)
Pages：7( 804-810 )