Study on the correlation between model for end-stage liver disease score and heart failure and its predictive value for the prognosis of heart failure

Tian Xue; Xing Xinyue; Li Hong

doi:10.3760/j.issn.1673-4777.2024.03.005

Abstract：Objective To investigate the correlation between model for end-stage liver disease(MELD)score and heart failure and its predictive value for the prognosis of heart failure.Methods The clinical data of 318 patients with heart failure who were hospitalized in Beijing Anzhen Hospital,Capital Medical University from January 2020 to December 2021 were retrospectively analyzed.The patients were followed up for 1 year,and according to the presence or absence of cardiac rehospitalization or death,they were divided into non-event group(189 cases)and event group(129 cases).The data differences between the above two groups were mainly compared.The correlation between MELD and heart failure and its predictive value for adverse events in patients with heart failure were analyzed.Results The incidence of adverse events,N-terminal pro-brain natriuretic peptide(NT-proBNP)levels,and left ventricular end diastolic diameter(LVEDD)increased with the increase of MELD score,while left ventricular ejection fraction(LVEF)decreased with the increase of MELD score(all P＜0.05).The levels of homocysteine,NT-proBNP,C-reactive protein,LVEDD,and MELD score in the event group were significantly higher than those in the non-event group,while the levels of albumin and LVEF were significantly lower than those in the non-event group(all P＜0.05).The MELD score was positively correlated with the levels of NT-proBNP and LVEDD(r=0.375,0.403),the positive correlation with LVEDD was stronger than that with NT-proBNP,and negatively correlated with LVEF(r=-0.392)(all P＜0.001).Multivariate Logistic regression analysis showed that increased MELD score was the strongest factor among the relevant factors for adverse events in patients with heart failure(odds ratio=6.557,95％confidence interval:3.082-26.841,P=0.004).The cut-off value of MELD score for predicting adverse events in patients with heart failure was 17,and the area under the receiver operating characteristic curve was 0.761,with a specificity of 61.5％and a sensitivity of 80.3％.The predictive value was better than NT-proBNP and LVEF(with an area under the curve of 0.658 and 0.682,respec-tively).Conclusions Increased MELD score is an independent risk factor for heart failure,and it has good clinical value in predicting the prognosis of heart failure.