Heart failure has a mortality rate that can range from 5 percent to 75 percent per year. Patients and clinicians have not had an easy way to estimate survival. The Seattle Heart Failure Model was developed using very simple clinical and laboratory variables. The model was derived by examining 1,125 heart failure patients, and validated in five additional groups, totalling 9,942 patients. The accuracy of the model was excellent.
"What is unique about this model is that one can estimate the change in an individual patient's survival by adding medications or devices used to treat heart failure," said Dr. Wayne C. Levy, associate professor of medicine in the Division of Cardiology at the UW. "For example, a heart failure patient treated with only digoxin and diuretic therapy with a 20 percent annual mortality rate will live about four years on average. But according to the Seattle Heart Failure Model, if you add an ACE inhibitor the patient will live five years, and if you add an ACE inhibitor and a beta blocker the patient will live six and a half years.
"If you use an ACE inhibitor, beta blocker and an aldosterone blocker, the patient makes it to eight years," Levy said. "And if you add an implantable cardiovertor defibrillator (ICD) you would make it to nine and a half years."
Heart failure medications are proven to be effective and are relatively inexpensive. However, in ADHERE, a 65,000-patient registry of heart failure patients admitted to the hospital, only 41 percent were taking an ACE inhibitor, and only 45 percent were on beta blockers.
"The question is: Why aren't they on these proven life-saving heart failure medicines? We are trying to encourage patients and physicians to use the medications and devices that we know will work," Levy said.
The model is available to health care providers at www.seattleheartfailuremodel.org.
MEDICA.de; Source: University of Washington