The MECKI score outperformed the CPX Risk score in predicting 2-year adverse events, with an AUC of 0.861 versus 0.728 in a mixed US cohort undergoing cardiopulmonary exercise testing.
Observational (n=803)
No
Does the MECKI score accurately predict the composite of death, heart failure hospitalization, heart transplantation, or LVAD implantation compared to the CPX Risk score in a mixed US cohort?
The MECKI score provides robust prognostic utility for predicting adverse heart failure events in a diverse US cohort, outperforming standard CPX-based risk assessments.
Effect estimate: AUC 0.861 for MECKI score vs AUC 0.728 for CPX Risk score (95% CI MECKI score 0.820–0.903; CPX Risk score 0.669–0.788)
p-value: p=<0.001
Abstract The Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score has demonstrated prognostic utility in European and Asian cohorts with heart failure with reduced ejection fraction (HFrEF). We sought to evaluate its performance in an American cohort. We retrospectively identified patients who underwent cardiopulmonary exercise testing (CPX) at our institution in 2022–2024 with data to calculate the MECKI and CPX Risk scores. The primary endpoint was a composite of death, heart failure admission, heart transplantation, or ventricular assist device. Survival analysis was assessed via Kaplan–Meier curves and log‐rank test, with ROC curves for comparison. Overall, 803 patients met criteria, with 451 (56%) female, 228 (28%) Black race, and median body mass index 29.4 (25.0–34.2) kg/m 2 . Pre‐existing HFrEF was present in 187 (23%) patients. 719 (90%), 41 (5%), and 43 (5%) patients achieved MECKI scores <10%, 10%–20%, and ≥20%, respectively, with stepwise increases in 2‐year risk of primary endpoints (log‐rank χ 2 = 196.0, p < 0.001). ROC curves demonstrated better performance of MECKI scores compared to CPX Risk scores. Events were similarly predicted in patients with HFrEF, with similar performances between the two scores. In conclusion, in a mixed American cohort the MECKI score demonstrated robust performance in predicting event‐free survival.
Mallepally et al. (Sun,) conducted a observational in Adults undergoing cardiopulmonary exercise testing with and without heart failure with reduced ejection fraction including a mixed racially diverse US cohort (n=803). MECKI score vs. CPX Risk score was evaluated on Composite of death, heart failure hospitalization, heart transplantation, or left ventricular assist device implantation within 2 years (AUC 0.861 for MECKI score vs AUC 0.728 for CPX Risk score, 95% CI MECKI score 0.820–0.903; CPX Risk score 0.669–0.788, p=<0.001). The MECKI score outperformed the CPX Risk score in predicting 2-year adverse events, with an AUC of 0.861 versus 0.728 in a mixed US cohort undergoing cardiopulmonary exercise testing.