Development and validation of R-hf risk score in acute heart failure patients in the Middle East


Illinois Masonic Medical Center


Objectives: The Rajan’s heart failure (R-hf) score was proposed to aid risk stratification in heart failure patients.

Methods: R-hf risk score is derived from the product estimated glomerular filtration rate [eGFR (mL/min)], left ventricular ejection fraction [ LVEF (%)], and haemoglobin levels [ Hb (g/dL)] divided by N-terminal pro-brain natriuretic peptide [NT proBNP (pg/mL)]. The aim of this study was to validate R-hf risk score in patients with acute decompensated heart failure (AHF). This was a multinational, multicentre, prospective registry of heart 2 failure from seven countries in the Middle East. Univariable and multivariable logistic regression was applied.

Results: A total of 776 patients (mean age: 62±14 years, 62% males; mean left ventricular ejection fraction: 33±14%) were included. Of these 459 (59%) presented with acute decompensated chronic heart failure (ADCHF). The R-hfrisk score group (≤5) was marginally associated with higher risk of all-cause cumulative mortality at 3- months (adjusted odds ratio (aOR), 4.28; 95% confidence interval (CI): 0.90-20.3; p=0.067) and was significantly at 12-months (aOR, 3.84; 95% CI: 1.23-12.0; p=0.021) when compared to those with the highest R score group (³50).

Conclusions: Lower R-hf risk scores are associated with increased risk of all-cause cumulative mortality at 3-months and 12-months. Risk score can be accessed at