TY - JOUR
T1 - Development and validation of multivariable models to predict mortality and hospitalization in patients with heart failure
AU - Voors, Adriaan A
AU - Ouwerkerk, Wouter
AU - Zannad, Faiez
AU - van Veldhuisen, Dirk J
AU - Samani, Nilesh J
AU - Ponikowski, Piotr
AU - Ng, Leong L
AU - Metra, Marco
AU - Ter Maaten, Jozine M
AU - Lang, Chim C
AU - Hillege, Hans L
AU - van der Harst, Pim
AU - Filippatos, Gerasimos
AU - Dickstein, Kenneth
AU - Cleland, John G
AU - Anker, Stefan D
AU - Zwinderman, Aeilko H
N1 - Funding Information:
BIOSTAT-CHF was funded by a grant from the European Commission (FP7-242209-BIOSTAT-CHF; EudraCT 2010?020808?29). N.J.S. holds a Chair funded by the British Heart Foundation and is an NIHR Senior Investigator. Conflict of interest: S.D.A. reports consultancy for Thermo Fisher, and Consultancy and Research Support from Vifor Pharma. K.D. has received honoraria and/or research support from the following device companies: Medtronic, Boston Scientific, St. Jude, Biotronik and Sorin; and the following pharmaceutical companies: Merck, Novartis, Amgen, Boehringer Ingelheim, Astra Zeneca, Pfizer, Bayer, GSK, Roche, Sanofi, Abbott, Otsuka, Leo, Servier, and Bristol Meyers Squibb. G.F. received fees and/or research grants from Novartis, Bayer, Cardiorentis, Vifor, Servier, Alere, and Abbott. M.M. reports consulting honoraria from Amgen, Bayer, Novartis, and Servier. A.A.V. reports consultancy fees and/or research grants from Alere, Amgen, Bayer, Boehringer Ingelheim, Cardio3Biosciences, Celladon, GSK, Merck/MSD, Novartis, Servier, Stealth Peptides, Singulex, Sphingotec, Trevena, Vifor, and ZS Pharma. All the other authors have no conflicts to report.
Publisher Copyright:
© 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology
PY - 2017/5
Y1 - 2017/5
N2 - INTRODUCTION: From a prospective multicentre multicountry clinical trial, we developed and validated risk models to predict prospective all-cause mortality and hospitalizations because of heart failure (HF) in patients with HF.METHODS AND RESULTS: BIOSTAT-CHF is a research programme designed to develop and externally validate risk models to predict all-cause mortality and HF hospitalizations. The index cohort consisted of 2516 patients with HF from 69 centres in 11 European countries. The external validation cohort consisted of 1738 comparable patients from six centres in Scotland, UK. Patients from the index cohort had a mean age of 69 years, 27% were female, 83% were in New York Heart Association (NYHA) class II-III and the mean left ventricular ejection fraction (LVEF) was 31%. The full prediction models for mortality, hospitalization owing to HF, and the combined outcome, yielded c-statistic values of 0.73, 0.69, and 0.71, respectively. Predictors of mortality and hospitalization owing to HF were remarkably different. The five strongest predictors of mortality were more advanced age, higher blood urea nitrogen and N-terminal pro-B-type natriuretic peptide, lower haemoglobin, and failure to prescribe a beta-blocker. The five strongest predictors of hospitalization owing to HF were more advanced age, previous hospitalization owing to HF, presence of oedema, lower systolic blood pressure and lower estimated glomerular filtration rate. Patients from the validation cohort were aged 74 years, 34% were female, 85% were in NYHA class II-III, and mean LVEF was 41%; c-statistic values for the full and compact model were comparable to the index cohort.CONCLUSION: A small number of variables, which are usually readily available in the routine clinical setting, provide useful prognostic information for patients with HF. Predictors of mortality were remarkably different from predictors of hospitalization owing to HF.
AB - INTRODUCTION: From a prospective multicentre multicountry clinical trial, we developed and validated risk models to predict prospective all-cause mortality and hospitalizations because of heart failure (HF) in patients with HF.METHODS AND RESULTS: BIOSTAT-CHF is a research programme designed to develop and externally validate risk models to predict all-cause mortality and HF hospitalizations. The index cohort consisted of 2516 patients with HF from 69 centres in 11 European countries. The external validation cohort consisted of 1738 comparable patients from six centres in Scotland, UK. Patients from the index cohort had a mean age of 69 years, 27% were female, 83% were in New York Heart Association (NYHA) class II-III and the mean left ventricular ejection fraction (LVEF) was 31%. The full prediction models for mortality, hospitalization owing to HF, and the combined outcome, yielded c-statistic values of 0.73, 0.69, and 0.71, respectively. Predictors of mortality and hospitalization owing to HF were remarkably different. The five strongest predictors of mortality were more advanced age, higher blood urea nitrogen and N-terminal pro-B-type natriuretic peptide, lower haemoglobin, and failure to prescribe a beta-blocker. The five strongest predictors of hospitalization owing to HF were more advanced age, previous hospitalization owing to HF, presence of oedema, lower systolic blood pressure and lower estimated glomerular filtration rate. Patients from the validation cohort were aged 74 years, 34% were female, 85% were in NYHA class II-III, and mean LVEF was 41%; c-statistic values for the full and compact model were comparable to the index cohort.CONCLUSION: A small number of variables, which are usually readily available in the routine clinical setting, provide useful prognostic information for patients with HF. Predictors of mortality were remarkably different from predictors of hospitalization owing to HF.
KW - Aged
KW - Europe/epidemiology
KW - Female
KW - Heart Failure/mortality
KW - Hospital Mortality/trends
KW - Hospitalization/trends
KW - Humans
KW - Male
KW - Predictive Value of Tests
KW - Prognosis
KW - Program Development
KW - Prospective Studies
KW - Risk Assessment
KW - Risk Factors
KW - Survival Rate/trends
KW - Ventricular Function, Left/physiology
KW - Heart failure
KW - Heart failure hospitalization
KW - Mortality
KW - Prediction model
UR - http://www.scopus.com/inward/record.url?scp=85014025080&partnerID=8YFLogxK
U2 - 10.1002/ejhf.785
DO - 10.1002/ejhf.785
M3 - Article
C2 - 28247565
SN - 1388-9842
VL - 19
SP - 627
EP - 634
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
IS - 5
ER -