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Revista Colombiana de Cardiología
Print version ISSN 0120-5633
Abstract
BOTERO-BUILES, Diana S.; SENIOR-SANCHEZ, Juan M.; VELASQUEZ-PENAGOS, Jesús A. and 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 Dec 23, 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.
Keywords : Pregnancy; Validity; Heart disease; Outcomes; Risk stratification; Cardio-Obstetrics.