Validation of R-hf risk score for risk stratification in ischemic heart failure patients : a prospective cohort study

Rajan, Rajesh and Soman, Suman Omana and Al Jarallah, Mohammed and Zhanna, Kobalava and Dashti, Raja and Al Zakwani, Ibrahim and Al Balool, Joud and Tse, Gary and Setiya, Parul and A. Brady, Peter and Al-Saber, Ahmad and Vijayaraghavan, Govindan (2022) Validation of R-hf risk score for risk stratification in ischemic heart failure patients : a prospective cohort study. Annals of Medicine and Surgery, 80. 104333. ISSN 2049-0801 (

[thumbnail of Rajan-etal-AMS-2022-Validation-of-R-hf-risk-score-for-risk-stratification-in-ischemic-heart-failure-patients]
Text. Filename: Rajan_etal_AMS_2022_Validation_of_R_hf_risk_score_for_risk_stratification_in_ischemic_heart_failure_patients.pdf
Final Published Version
License: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 logo

Download (1MB)| Preview


Background: The aim of this study was to validate R-heart failure (R-hf) risk score in ischemic heart failure patients. Methods: We prospectively recruited a cohort of 179 ischemic and 107 non-ischemic heart failure patients. This study mainly focused on ischemic heart failure patients. Non-ischemic heart failure patients were included for the purpose of validation of the risk score in various heart failure groups. Patients were stratified in high risk, moderate risk and low risk groups according to R-hf risk score. Results: A total of 179 participants with ischemic heart failure were included. Based on R-hf risk score, 82 had high risk, 50 had moderate risk and 47 had low risk heart failure scores. More than half of the patients having R-hf score of <5 had renal failure (n = 91, 50.8%) and anemia (n = 99, 55.3%). Notably, HFrEF was more prevalent in patients with high risk score (74, 90.2%). Patients with high risk score had significantly higher creatinine (2.63 ± 1.96, p < 0.001), Troponin-T HS (59.9 ± 38.0, p < 0.001) and PRO BNP (17842 ± 6684, p < 0.001) when compared to patients with low and moderate risk score. Patients with low risk score had significantly higher Hb (13.2 ± 1.85, p < 0.001), Albumin (3.69 ± 0.42, p < 0.001) and GFR (90.0 ± 8.04, p < 0.001). A R-hf score of <5 was a significant predictor of mortality in ischemic (OR = 50.34; 95% CI [16.94–194.00, p < 0.001) and non-ischemic (OR = 46.34; 95% CI [12.97–225.39], p < 0.001) heart failure patients. Conclusions: Lower R-hf risk score is a significant predictor of mortality in ischemic and non-ischemic heart failure patients. Risk score can be accessed at


Rajan, Rajesh, Soman, Suman Omana, Al Jarallah, Mohammed, Zhanna, Kobalava, Dashti, Raja, Al Zakwani, Ibrahim, Al Balool, Joud, Tse, Gary, Setiya, Parul, A. Brady, Peter, Al-Saber, Ahmad ORCID logoORCID: and Vijayaraghavan, Govindan;