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Revista Colombiana de Cardiología
versión impresa ISSN 0120-5633
Resumen
BOTERO-BUILES, Diana S.; SENIOR-SANCHEZ, Juan M.; VELASQUEZ-PENAGOS, Jesús A. y MUNOZ-ORTIZ, Edison. Validation of the CARPREG II risk stratification model and the WHO scale in pregnant women with heart disease. Rev. Colomb. Cardiol. [online]. 2022, vol.29, n.5, pp.530-540. Epub 23-Dic-2022. ISSN 0120-5633. https://doi.org/10.24875/rccar.21000089.
Introduction:
In pregnant women with heart disease, risk stratification models for adverse outcomes allow guiding clinical decisions and establish monitoring and management strategies according to each category.
Objective:
To validate CARPREG II and WHOm adverse cardiac outcome risk prediction models in this population.
Materials and methods:
Validation and comparison study of two risk prediction models in a prospective cohort of pregnant women with heart disease, assessed by a team cardio-obstetrician in a middle-income country. We assessed cardiovascular and perinatal outcomes and determined the calibration and level of discrimination of these tools.
Results:
Among 328 pregnant women (27 years SD = 7), 33% (n = 110) had congenital heart disease, 30% (n = 98) arrhythmias, 14% (n = 46) valvular pathologies and 9% (n = 29) cardiomyopathies. A cardiac event occurred in 15% (10% primary and 5% secondary). Discrimination of both models was adequate (AUC-ROC 0.74 CI 95% 0.64-0.84 for CARPREG II and 0.77 for WHOm 95% CI 0.69-0.86). The calibration is also good (Hosmer-Lemeshow >0.05). The Numerical variables of fraction of ejection and systolic pressure of the pulmonary artery can improve the predictive ability of CARPREG II.
Conclusions:
The CARPREG II and WHOm risk stratification models have good ability to predict the risk of adverse cardiac outcomes and are adjusted to our pregnant women with heart disease.
Palabras clave : Pregnancy; Validity; Heart disease; Outcomes; Risk stratification; Cardio-Obstetrics.