BIOSTAT prediction model 27MAY16 EurHJ.pdf (1.2 MB)

Development and validation of multivariable models to predict mortality and hospitalization in patients with heart failure.

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journal contribution
posted on 08.12.2017, 16:15 by Adriaan A. Voors, Wouter Ouwerkerk, Faiez Zannad, Dirk J. van Veldhuisen, Nilesh J. Samani, Piotr Ponikowski, Leong L. Ng, Marco Metra, Jozine M. Ter Maaten, Chim C. Lang, Hans L. Hillege, Pim van der Harst, Gerasimos Filippatos, Kenneth Dickstein, John G. Cleland, Stefan D. Anker, Aeilko H. Zwinderman
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.

Funding

BIOSTAT-CHF was funded by a grant from the European Commission (FP7-242209-BIOSTATCHF; EudraCT 2010-020808-29)

History

Citation

European Journal of Heart Failure, 2017, 19 (5), pp. 627-634

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Cardiovascular Sciences

Version

AM (Accepted Manuscript)

Published in

European Journal of Heart Failure

Publisher

Wiley for European Society of Cardiology

issn

1388-9842

eissn

1879-0844

Acceptance date

05/12/2016

Copyright date

2017

Available date

01/03/2018

Publisher version

http://onlinelibrary.wiley.com/doi/10.1002/ejhf.785/abstract

Notes

The file associated with this record is under embargo until 12 months after publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.

Language

en