S.LIU1, J.LEE1, J-J.LIU1, J.TANG1, K.ANG1, SC.LIM1
Khoo Teck Puat Hospital1
Heart failure (HF) is an often unrecognized complication in individuals with type 2 diabetes (T2D) which is associated with repeated hospitalization and high mortality. We aim to study whether the new TRS-HF score derived from large clinical trials may identify patients with high risk for heart failure hospitalization (HHF) in real world in Asians with T2D.
1,966 participants from KTPH SMART2D cohort were followed for a median of 7.3 (IQR 6.8-7.7) years and 119 incident HHF were identified. TRS-HF is comprised of five components with each being assigned an integer 1 or 0 score: estimated glomerular filtration rate, albuminuria and histories of heart failure, atrial fibrillation and coronary artery disease.
According to TRS-HF score, 48% cohort participants were categorized as low risk (0 point), 29% as intermediate risk (1 point), 15% as high risk (2 points) and 8% as having very high risk (≥3 points). Cox regression analysis showed that the group with very high-risk had 8.6-fold (95% CI 4.1-18.0) increased risk for HHF after adjustment for demographic and multiple clinical risk factors. Further analysis showed that TRS-HF risk score had a sensitivity of 72%, specificity of 81% and high discrimination for 5-year HHF prediction (AUC 0.81, 95% CI 0.76-0.86).
TRS-HF score may be an easily applicable tool to stratify risk for HHF in multi-ethnic Asians with T2D. Future studies are warranted to examine whether application of this score may lead to early intervention and reduction of HHF hospitalization in real clinical setting.