Use of the AHEAD score in acute heart failure

Introduction

Heart failure (HF) is a major public-health problem. Recognition of predictors of an unfavourable outcome in HF is very important. With time many scores have been used to evaluate prognostic in HF. AHEAD score is based on the analysis of co-morbidities for the estimation of the short and long term prognosis of patients hospitalized for AHF.

Objective

The aim of this paper is to find a correlation between AHEAD score and both mortality and re-hospitalization.

Method

In this prospective study we enrolled 108 patients admitted to our cardiology department between 2021 and 2023 for acute HF. AHEAD score was calculated for each patient and the correlation between this ratio and mortality, re-hospitalizations, was studied.

Results

The mean age was 63.5 ± 11.9 years (79.6% men). Ischemic HF was the most common etiology (57.4%). Of these patients 30.6% were aged > 70 years, 28.7% had atrial fibrillation (AF), 42.2% had diabetes mellitus, 23.1% had anemia, and 16.7% had creatinine > 130 mmol/l. The mean AHEAD score was 1.4 ± 1. No patient had a score equal to 5. The one-year mortality rates in patients with AHEAD score of 0 to 4 were 0%, 2.5%, 10.7%, 0%, 40% respectively. The re-hospitalization rates in patients with AHEAD score of 0 to 4 were 8.7%, 5%, 17.9%, 0%, 20% respectively. The ROC curve analysis revealed a correlation between the AHEAD score and the occurrence of mortality (AUC = 0.763, P = 0.031) with a cutoff value of 2 with a sensitivity of 83.3% and a specificity of 60.8%. No correlation was found between the AHEAD score and re-hospitalization.

Conclusion

Our findings show that the AHEAD score estimates with good performance the mortality in patients with AHF. These results provide new insights into the evaluation of AHF patients.