Turk Kardiyol Dern Ars. 2023; 51(2): 104-111 | DOI: 10.5543/tkda.2022.99448

Modified Glasgow Prognostıc Score May Be Useful to Predict Major Adverse Cardiac Events in Heart Failure Patients Undergone Cardiac Resynchronization Treatment

Güney Erdogan¹, Mustafa Yenerçağ², Melisa Uçar¹, Onur Öztürk¹, Onur osman Şeker¹, Osman Can Yontar¹, Ender Özgün Çakmak³, Ali Karagöz³, İrfan Şahin⁴, Uğur Arslan^1
1University of Health Sciences Turkey, Samsun Training and Research Hospital, Cardiology Clinic, Samsun, Türkiye
²Ordu University, Training and Research Hospital, Cardiology Clinic, Ordu, Türkiye
³University of Health Sciences Turkey Kartal Kosuyolu Research and Training Hospital, Cardiology Clinic,, İstanbul, Türkiye
⁴University of Health Sciences, Bağcılar Training and Research Hospital, Department of Cardiology, Istanbul, Türkiye

OBJECTIVE
Whether modified Glasgow prognostic score predicts prognosis in patients with cardiac resynchronization therapy with defibrillation is unknown. Our aim was to investigate the association of modified Glasgow prognostic score with death and hospitalization in cardiac resynchronization therapy with defibrillation patients.


METHODS
A total of 306 heart failure with reduced ejection fraction patients who underwent cardiac resynchronization therapy with defibrillation implantation were categorized into 3 groups based on their modified Glasgow prognostic score categorical levels.
C-reactive protein >10 mg/L or albumin <35 g/L was assigned 1 point each and the patients were classified into 0, 1, and 2 points, respectively. Remodeling was determined according to the clinical event and myocardial remodeling criteria. Major adverse cardiac events were defined as mortality and/or hospitalization for heart failure.


RESULTS
Age, New York Heart Association functional class, modified Glasgow prognostic score prior to cardiac resynchronization therapy with defibrillation, sodium levels, and left atrial diameter were higher in the major adverse cardiac events(+) group. Age, left atrial diameter, and higher modified Glasgow prognostic score were found to be predictors of heart failure hospitalization/death in multivariable penalized Cox regression analysis. Besides, patients with lower modified Glasgow prognostic score showed better reverse left ventricular remodeling demonstrated by increase in left ventricle ejection fraction and decline in left ventricle end systolic volume.


CONCLUSION
Modified Glasgow prognostic score prior to cardiac resynchronization therapy with defibrillation can be used as a predictor of long-term heart failure hospitalization and death in addition to age and left atrial diameter. These results can guide the patient selection for cardiac resynchronization therapy with defibrillation therapy and highlight the importance of nutritional status.

Keywords: Modifi, ed Glasgow prognostic score, long-term prognosis, cardiac resynchronization therapy, heart failure with reduced EF, nutritional treatment

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