@article{e2a0e033ff484b05967e8bd424d0289e,
title = "A registry-based algorithm to predict ejection fraction in patients with heart failure",
abstract = "Aims: Left ventricular ejection fraction (EF) is required to categorize heart failure (HF) [i.e. HF with preserved (HFpEF), mid-range (HFmrEF), and reduced (HFrEF) EF] but is often not captured in population-based cohorts or non-HF registries. The aim was to create an algorithm that identifies EF subphenotypes for research purposes. Methods and results: We included 42 061 HF patients from the Swedish Heart Failure Registry. As primary analysis, we performed two logistic regression models including 22 variables to predict (i) EF≥ vs. '50% and (ii) EF≥ vs. '40%. In the secondary analysis, we performed a multivariable multinomial analysis with 22 variables to create a model for all three separate EF subphenotypes: HFrEF vs. HFmrEF vs. HFpEF. The models were validated in the database from the CHECK-HF study, a cross-sectional survey of 10 627 patients from the Netherlands. The C-statistic (discrimination) was 0.78 [95% confidence interval (CI) 0.77–0.78] for EF ≥50% and 0.76 (95% CI 0.75–0.76) for EF ≥40%. Similar results were achieved for HFrEF and HFpEF in the multinomial model, but the C-statistic for HFmrEF was lower: 0.63 (95% CI 0.63–0.64). The external validation showed similar discriminative ability to the development cohort. Conclusions: Routine clinical characteristics could potentially be used to identify different EF subphenotypes in databases where EF is not readily available. Accuracy was good for the prediction of HFpEF and HFrEF but lower for HFmrEF. The proposed algorithm enables more effective research on HF in the big data setting.",
keywords = "Ejection fraction, Electronic health records, HFmrEF, HFpEF, HFrEF, Heart failure, Prediction",
author = "Alicia Uijl and Lund, {Lars H} and Ilonca Vaartjes and Brugts, {Jasper J} and Linssen, {Gerard C} and Asselbergs, {Folkert W} and Hoes, {Arno W} and Ulf Dahlstr{\"o}m and Stefan Koudstaal and Gianluigi Savarese",
note = "Funding Information: The Swedish Heart Failure Registry is funded by the Swedish National Board of Health and Welfare, the Swedish Association of Local Authorities and Regions, the Swedish Society of Cardiology, and the Swedish Heart‐Lung Foundation. Servier, the Netherlands, partially funded the inclusion of data and software program for CHECK‐HF. The CHECK‐HF steering committee (J. B., G. L., H. P. B., and A. H.) received no funding for this project. The current study was initiated by the authors and was designed, conducted, interpreted, and reported independently of the sponsor. This work has received support from the EU/EFPIA Innovative Medicines Initiative 2 Joint Undertaking BigData@Heart (grant no. 116074). This study was supported by grants to L. H. L.'s institution from the Swedish Research Council (grants 2013‐23897‐104604‐23 and 523‐2014‐2336), the Swedish Heart Lung Foundation (grants 20150557 and 20170841), and the Stockholm County Council (grants 20140220 and 20170112). F. W. Asselbergs is supported by UCL Hospitals NIHR Biomedical Research Centre. I. Vaartjes is supported by the Dutch Heart Foundation, a part of {\textquoteleft}Facts and Figures{\textquoteright}. Funding Information: The Swedish Heart Failure Registry is funded by the Swedish National Board of Health and Welfare, the Swedish Association of Local Authorities and Regions, the Swedish Society of Cardiology, and the Swedish Heart-Lung Foundation. Servier, the Netherlands, partially funded the inclusion of data and software program for CHECK-HF. The CHECK-HF steering committee (J.?B., G.?L., H.?P.?B., and A.?H.) received no funding for this project. The current study was initiated by the authors and was designed, conducted, interpreted, and reported independently of the sponsor. This work has received support from the EU/EFPIA Innovative Medicines Initiative 2 Joint Undertaking BigData@Heart (grant no. 116074). This study was supported by grants to L.?H.?L.'s institution from the Swedish Research Council (grants 2013-23897-104604-23 and 523-2014-2336), the Swedish Heart Lung Foundation (grants 20150557 and 20170841), and the Stockholm County Council (grants 20140220 and 20170112). F.?W. Asselbergs is supported by UCL Hospitals NIHR Biomedical Research Centre. I. Vaartjes is supported by the Dutch Heart Foundation, a part of ?Facts and Figures?. Publisher Copyright: {\textcopyright} 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology",
year = "2020",
month = oct,
day = "1",
doi = "10.1002/ehf2.12779",
language = "English",
volume = "7",
pages = "2388--2397",
number = "5",
}