Seattle heart failure model

1. 11/30/13 Seattle Heart Failure Model
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University of Washington
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Media contact:Craig Degginger, (206)616-3192
Email: craigd@u.washington.edu
March 16th, 2006
For immediate release:
Seattle Heart Failure Model is able to accurately predict survival and the
impact of medications and devices for patients with heart failure
A new model developed at the University of Washington provides an accurate estimate of
one-, two-, and three-year survival rates and average years of survival for patients with
heart failure. The model incorporates medications and devices that are used to treat heart
failure and how altering these affect survival.
The Seattle Heart Failure Model was created by Dr. Wayne C. Levy, associate professor of
medicine in the Division of Cardiology at the UW, in collaboration with 13 co-authors. It is
now available online at http://circ.ahajournals.org/ and will be published March 21 in the
journal Circulation.
Heart failure has a mortality rate that can range from 5 percent to 75 percent per year.
Patients and clinicians have not had an easy way to estimate survival. The Seattle Heart
Failure Model was developed using very simple clinical and laboratory variables that are
available to any health care provider. Some of these include age, gender, blood pressure,
weight, heart failure medications/devices, and simple laboratory variables like hemoglobin,
cholesterol, uric acid, and serum sodium. The model was derived by examining 1,125 heart
failure patients, and validated in five additional groups, totaling 9,942 patients. The accuracy
of the model was excellent. “What is unique about this model is that one can estimate the
change in an individual patient’s survival by adding medications or devices used to treat
heart failure,” Levy said. “For example, a heart failure patient treated with only digoxin and
diuretic therapy with a 20 percent annual mortality rate will live about four years on average.
But according to the Seattle Heart Failure Model, if you add an ACE inhibitor the patient will
live five years, and if you add an ACE inhibitor and a beta blocker the patient will live six and
a half years.
“If you use an ACE inhibitor, beta blocker and an aldosterone blocker, the patient makes it to
eight years, or double the original life span,” Levy said. “And if you add an implantable
cardiovertor defibrillator (ICD) you would make it to nine and a half years.” Heart failure
medications are proven to be effective and are relatively inexpensive, as many are available
in a generic formulation. However, in ADHERE, a 65,000-patient registry of heart failure
patients admitted to the hospital, only 41 percent were taking an ACE inhibitor, and only 45
percent were on beta blockers. “The question we are asking is: Why aren’t they on these
proven life-saving heart failure medicines?” Levy said. “This model will actually illustrate why
patients need to take them. The same applies to cardiac devices, such as biventricular
pacemakers, implantable cardiovertor defibrillators, or left-ventricular assist devices. We are
trying to encourage patients and physicians to use the medications and devices that we
know will work in our heart failure patients,” he said.
The model may also be valuable in determining who should receive a heart transplant.
“Unlike other organs, there is no ‘score’ for either listing patients for a heart transplant or to
allocate who receives an organ,” Levy said. “This model could help determine who should be
listed for a heart transplant and to allocate the heart to the highest-risk patient on the
waiting list.”
Dr. David T. Linker, an associate professor of medicine in the Division of Cardiology at the UW
and co-author of the paper, has developed a Web-based application to make this interactive
model available to health care providers at www.seattleheartfailuremodel.org.
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