BACKGROUND: The role of co-morbidities in the prognosis of patients hospitalized for AHF was examined using the AHEAD (A--atrial fibrillation, H--haemoglobin<130 g/l for men and 120 g/l for women (anaemia), E--elderly (age>70years), A--abnormal renal parameters (creatinine>130 μmol/l), D--diabetes mellitus) scoring system. METHODS: AHEAD--multicentre prospective Czech registry of AHF patients; GREAT registry--international cohort of AHF patients. Data from 5846 consecutive patients hospitalized for AHF (AHEAD registry; derivation cohort) were analysed to build the AHEAD score. Each risk factor of the AHEAD score was counted as 1 point. The model was validated externally using an international cohort of similar patients in the GREAT registry (6315). RESULTS: Main outcome was one year all-cause mortality. The mean age of patients was 72±12 years, with 61.6% of patients aged >70 years; 43.4% were women. Atrial fibrillation was present in 30.7%, anaemia in 38.2%, creatinine>130 mmol/l (abnormal renal parameters) in 30.1%, and diabetes mellitus in 44.0%. The mean AHEAD score was 2.1. In patients with AHEAD scores of 0-5, the one-year mortality rates were 13.6%, 23.4%, 32.0%, 41.1%, 47.7%, and 58.2%, respectively (p<0.001), and the 90 month mortality rates were 35.1%, 57.3%, 73.5%, 84.8%, 88.0%, and 91.7%, respectively (p<0.001). CONCLUSION: The AHEAD is a simple scoring system based on the analysis of co-morbidities for the estimation of the short and long term prognosis of patients hospitalized for AHF.

2nd Department of Cardiovascular Internal Medicine 1st Medical Faculty Charles University Prague and General Teaching Hospital of Prague Prague Czech Republic

Department of Anesthesiology and Critical Care Medicine Saint Louis Lariboisiere University Hospital Paris France; UMR S 942 Inserm Paris France

Department of Cardiology Institute of Clinical and Experimental Medicine Prague Czech Republic

Department of Cardiology Na Homolce Hospital Prague Czech Republic

Department of Cardiology University Hospital Brno Brno Czech Republic; Department of Cardiovascular Disease International Clinical Research Center University Hospital St Anne's Brno Czech Republic

Department of Cardiology University Hospital Brno Brno Czech Republic; Medical Faculty Masaryk University Brno Czech Republic; Department of Cardiovascular Disease International Clinical Research Center University Hospital St Anne's Brno Czech Republic

Department of Internal Medicine Hospital Frydek Mistek Frydek Mistek Czech Republic

Department of Internal Medicine University Hospital Olomouc Olomouc Czech Republic

Institute of Biostatistics and Analysis Faculty of Medicine Masaryk University Brno Czech Republic

Kralovske Vinohrady University Hospital and the 3rd Faculty of Medicine Charles University Prague Czech Republic

Medical Faculty Masaryk University Brno Czech Republic; 1st Department of Cardiovascular Internal Medicine University Hospital St Anne's Brno Czech Republic

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