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

The Seattle Heart Failure Model was created by Wayne C. Levy, at the UW, in collaboration with 13 co-authors.

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 that are available 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 heart failure patients, and validated in five additional groups, totaling 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," Levy said. " 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, or double the original life span," Levy said. " And if you add an implantable cardioverter defibrillator ( ICD ) you would make it to nine and a half years."

Heart failure medications are proven to be effective and are relatively inexpensive, as many are available in a generic formulation. 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.

Source: University of Washington, 2006


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