Codina, PauDobarro Pérez, DavidJuan Bagudá, Javier deFrutos, Fernando deLupón, JosepBayés Genís, AntoniGonzález Costello, JoséSpanish LEVO‐D registry2023-11-302023-11-302023Codina, P., Dobarro, D., Juan-Bagudá, J., Frutos, F., Lupón, J., Bayés-Genís, A., González-Costello, J., & Spanish LEVO‐D registry Collaborators (2023). Heart failure risk scores in advanced heart failure patients: insights from the LEVO-D registry. ESC Heart Failure, 10(5), 2875–2881. https://doi.org/10.1002/ehf2.144002055-5822http://hdl.handle.net/11268/12409Aims: The prevalence of advanced heart failure (HF) is increasing due to the growing number of patients with HF and their better treatment and survival. There is a scarcity of data on the accuracy of HF web-based risk scores in this selected population. This study aimed to assess mortality prediction performance of the Meta-Analysis Global Group in Chronic HF (MAGGIC-HF) risk score and the model of the Barcelona Bio-HF Risk Calculator (BCN-Bio-HF) containing N terminal pro brain natriuretic peptide in HF patients receiving intermittent inotropic support with levosimendan as destination therapy. Methods and results: Four hundred and three advanced HF patients from 23 tertiary hospitals in Spain receiving intermittent inotropic support with levosimendan as destination therapy were included. Discrimination for all-cause mortality was compared by area under the curve (AUC) and Harrell's C-statistic at 1 year. Calibration was assessed by calibration plots comparing observed versus expected events based on estimated risk by each calculator. The included patients were predominantly men, aged 71.5 [interquartile range 64-78] years, with reduced left ventricular ejection fraction (27.5 ± 9.4%); ischaemic heart disease was the most prevalent aetiology (52.5%). Death rate at 1 year was 26.8%, while the predicted 1-year mortality by BCN-Bio-HF and MAGGIC-HF was 17.0% and 22.1%, respectively. BCN-Bio-HF AUC was 0.66 (Harrell's C-statistic 0.64), and MAGGIC-HF AUC was 0.62 (Harrell's C-statistic 0.61). Conclusions: The two evaluated risk scores showed suboptimal discrimination and calibration with an underestimation of risk in advanced HF patients receiving levosimendan as destination therapy. There is a need for specific scores for advanced HF.engAtribución-NoComercial 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc/4.0/Insuficiencia cardíacajournal article10.1002/ehf2.14400open accessEnfermedad cardiovascularMedicina preventivaRecopilación de datos