Seattle heart failure model

11/30/13 Seattle Heart Failure Model

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Media contact:Craig Degginger, (206)616-3192Email: craigd@u.washington.edu

March 16th, 2006

For immediate release:

Seattle Heart Failure Model is able to accurately predict survival and theimpact of medications and devices for patients with heart failure

A new model developed at the University of Washington provides an accurate estimate ofone-, two-, and three-year survival rates and average years of survival for patients withheart failure. The model incorporates medications and devices that are used to treat heartfailure and how altering these affect survival.

The Seattle Heart Failure Model was created by Dr. Wayne C. Levy, associate professor ofmedicine in the Division of Cardiology at the UW, in collaboration with 13 co-authors. It isnow available online at http://circ.ahajournals.org/ and will be published March 21 in thejournal Circulation.

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 HeartFailure Model was developed using very simple clinical and laboratory variables that areavailable to any health care provider. Some of these include age, gender, blood pressure,weight, heart failure medications/devices, and simple laboratory variables like hemoglobin,cholesterol, uric acid, and serum sodium. The model was derived by examining 1,125 heartfailure patients, and validated in five additional groups, totaling 9,942 patients. The accuracyof the model was excellent. “What is unique about this model is that one can estimate thechange in an individual patient’s survival by adding medications or devices used to treatheart failure,” Levy said. “For example, a heart failure patient treated with only digoxin anddiuretic 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 willlive five years, and if you add an ACE inhibitor and a beta blocker the patient will live six anda half years.

“If you use an ACE inhibitor, beta blocker and an aldosterone blocker, the patient makes it toeight years, or double the original life span,” Levy said. “And if you add an implantablecardiovertor defibrillator (ICD) you would make it to nine and a half years.” Heart failuremedications are proven to be effective and are relatively inexpensive, as many are availablein a generic formulation. However, in ADHERE, a 65,000-patient registry of heart failurepatients admitted to the hospital, only 41 percent were taking an ACE inhibitor, and only 45percent were on beta blockers. “The question we are asking is: Why aren’t they on theseproven life-saving heart failure medicines?” Levy said. “This model will actually illustrate whypatients need to take them. The same applies to cardiac devices, such as biventricularpacemakers, implantable cardiovertor defibrillators, or left-ventricular assist devices. We aretrying to encourage patients and physicians to use the medications and devices that weknow will work in our heart failure patients,” he said.

The model may also be valuable in determining who should receive a heart transplant.“Unlike other organs, there is no ‘score’ for either listing patients for a heart transplant or toallocate who receives an organ,” Levy said. “This model could help determine who should belisted for a heart transplant and to allocate the heart to the highest-risk patient on thewaiting list.”

Dr. David T. Linker, an associate professor of medicine in the Division of Cardiology at the UW

and co-author of the paper, has developed a Web-based application to make this interactivemodel available to health care providers at www.seattleheartfailuremodel.org.

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