VALIANT Heart Failure Risk Score

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Clinical Use

Predict future heart failure hospitalization in patients with stable acute myocardial infarction

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VARIANT study assessed the risk of an initial hospitalization for heart failure in 11,040 patients with acute myocardial infarction, without a prior history of heart failure, who had no major non-fatal cardiovascular events or deaths within 45 days of randomization. An integer-based risk score was developed using the parameter estimates of the 8 strongest predictors.


VALIANT heart failure risk scoring
Factor Assign points If patient
Age 0 is 50 or younger
4 is 51–60 years
5 is 61–70 years
9 is 71–80 years
10 is older than 80
Race 0 is Caucasian or Asian
6 is African-American
4 is any other race
Diabetes 0 does not have diabetes
5 has diabetes
Prior MI 0 has not had a prior MI
5 has had a prior MI
PVD 0 does not have PVD
5 has PVD
LBBB 0 does not have new LBBB
5 has new LBBB
Killip Class 0 is Killip Class 1 or 2
3 is Killip Class 3 or 4
NYHA class at 45 days 0 is Class I
3 is Class II
5 is Class III
9 is Class IV


The graph below demonstrates distribution of scores and heart failure hospitalization event rate in each score category.

VALIANT Heart Failure Risk Score

European Heart Journal, Volume 29, Issue 6, 1 March 2008 1

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1. Eldrin F. Lewis, Eric J. Velazquez, Scott D. Solomon, Anne S. Hellkamp, John J.V. McMurray, Jasmine Mathias, Jean-Lucien Rouleau, Aldo P. Maggioni, Karl Swedberg, Lars Kober, Harvey White, Anthony J. Dalby, Gary S. Francis, Faiez Zannad, Robert M. Califf, and Marc A. Pfeffer. Predictors of the first heart failure hospitalization in patients who are stable survivors of myocardial infarction complicated by pulmonary congestion and/or left ventricular dysfunction: a VALIANT study. Eur Heart J. 2008 Mar;29(6):748-56. Abstract


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Developer: Sirikarn Napan, MD, FACC