A Quantitative Chinese Medicine-Derived Dampness Score, Heart Failure Staging, and 12-Month Major Adverse Cardiovascular Events: A Prospective Cohort Study

Introduction: Chinese medicine (CM) conceptualizes “dampness” as a burden of specific symptoms and signs, yet its quantitative relationship with biomedically defined heart failure (HF) stages and prognosis remains unclear. The authors evaluated a CM-derived dampness score in relation to the updated HF stages and 12-month major adverse cardiovascular events (MACEs). Methods: The authors prospectively enrolled adults hospitalized for cardiovascular care between 2023 and 2025. At baseline, clinicians assigned HF Stages A–D as per guidelines. Dampness manifestations were scored with a structured CM scale, and patients were followed for 12 months for MACEs. They compared the dampness burden across stages and used logistic regression and restricted cubic spline models to examine its association with MACEs. Results: Among 797 patients, the prevalence of dampness syndrome increased from 40.4% in Stage A to 88.1% in Stage D, and the mean dampness score increased from 6.2 ± 2.1 to 24.3 ± 5.6 ( p < 0.001). During the 12-month follow-up period, 141 of 738 participants (19.1%) experienced MACEs. Each 1-point increase in the dampness score was independently associated with higher odds of MACEs (adjusted odds ratio = 1.17, 95% confidence interval: 1.13–1.20; p < 0.001), and the dose–response curve was approximately linear. Conclusions: In this cohort, CM-defined dampness manifestations increased across HF stages and were linearly associated with the 12-month risk of MACEs. A simple quantitative dampness score may complement conventional risk assessment and provide a pragmatic way to integrate CM evaluation into routine HF management.