Multivariable Cox regression analysis showed that the MELD-XI score remained a significant predictor of MACE (hazard ratio 1.36, confidence interval 1.17–1.58, P<0.001) even after adjusting for patient characteristics, such as sex, functional status, estimated glomerular filtration rate, and cardiac function.
In Kaplan-Meier analysis, the high score group had significantly worse MACE-free survival compared with the low score group (log-rank, P<0.001). During a mean follow-up period of 8.6 years (interquartile range 4.4–11.4 years), MACE was noted in 51 patients, including HF hospitalization in 37, cardiac death in 8, and lethal ventricular arrhythmias in 6. The major adverse cardiac event (MACE) was defined as a composite of cardiac death, HF hospitalization, and lethal ventricular arrhythmias. The cutoff value of MELD-XI score was determined based on the survival classification and regression tree (CART) analysis. We compared the long-term outcomes between the high (≥10.4) and the low (<10.4) score groups. MELD-XI score was calculated as follows 11.76 x ln(serum creatinine) + 5.11 x ln(serum total bilirubin) + 9.44. We retrospectively examined 637 ACHD patients (mean age 31.0 years) who visited our Tohoku University hospital from 1995 to 2015. In the present study, we examined whether the score also has the prognostic value in this population. The Model for End-Stage Liver Disease eXcluding INR (MELD-XI) score was originally developed to assess cirrhotic patients and has the prognostic value for heart failure (HF) patients. However, little is known about the predictive factors for long-term outcome. Patients with adult congenital heart disease (ACHD) are at increased risk of developing late cardiovascular complication.
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