The first prognostic model for stroke and death in patients with systolic heart failure
Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved..
BACKGROUND: Patients with systolic heart failure (HF) are at increased risk of both ischemic stroke and death. Currently, no risk scores are available to identify HF patients at high risk of stroke or death. The Warfarin vs. Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) trial studied 2305 HF patients, in sinus rhythm, followed for up to 6 years (3.5±1.5 years). This trial showed no overall difference in those treated with warfarin vs aspirin with regard to death or stroke. The present study develops the first prognostic model to identify patients at higher risk of stroke or death based on their overall risk profile.
METHODS AND RESULTS: A scoring algorithm using 8 readily obtainable clinical characteristics as predictors, age, gender, hemoglobin, blood urea nitrogen, ejection fraction, diastolic blood pressure, diabetes status, and prior stroke or transient ischemic attack (C-index=0.65, 95% CI: 0.613-0.681), was developed. It was validated internally using a bootstrap method. In predicting 1-year survival for death alone, our 8-predictor model had an AUC of 0.63 (95% CI: 0.579-0.678) while the 14-predictor Seattle model had an AUC of 0.72. The Seattle model did not report stroke.
CONCLUSIONS: This novel prognostic model predicts the overall risk of ischemic stroke or death for HF patients. This model compares favorably for death with the Seattle model and has the added utility of including stroke as an endpoint. Use of this model will help identify those patients in need of more intensive monitoring and therapy and may help identify appropriate populations for trials of new therapies.
CLINICAL TRIAL REGISTRATION: http://www.Clinicatrials.govNCT00041938.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2016 |
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| Erschienen: |
2016 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:68 |
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| Enthalten in: |
Journal of cardiology - 68(2016), 2 vom: 14. Aug., Seite 100-3 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Freudenberger, Ronald S [VerfasserIn] |
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| Links: |
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| Themen: |
5Q7ZVV76EI |
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| Anmerkungen: |
Date Completed 08.06.2017 Date Revised 02.12.2018 published: Print-Electronic ClinicalTrials.gov: NCT00041938 Citation Status MEDLINE |
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| doi: |
10.1016/j.jjcc.2015.09.014 |
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| funding: |
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| PPN (Katalog-ID): |
NLM254453422 |
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| 100 | 1 | |a Freudenberger, Ronald S |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The first prognostic model for stroke and death in patients with systolic heart failure |
| 264 | 1 | |c 2016 | |
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| 500 | |a Date Completed 08.06.2017 | ||
| 500 | |a Date Revised 02.12.2018 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT00041938 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Patients with systolic heart failure (HF) are at increased risk of both ischemic stroke and death. Currently, no risk scores are available to identify HF patients at high risk of stroke or death. The Warfarin vs. Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) trial studied 2305 HF patients, in sinus rhythm, followed for up to 6 years (3.5±1.5 years). This trial showed no overall difference in those treated with warfarin vs aspirin with regard to death or stroke. The present study develops the first prognostic model to identify patients at higher risk of stroke or death based on their overall risk profile | ||
| 520 | |a METHODS AND RESULTS: A scoring algorithm using 8 readily obtainable clinical characteristics as predictors, age, gender, hemoglobin, blood urea nitrogen, ejection fraction, diastolic blood pressure, diabetes status, and prior stroke or transient ischemic attack (C-index=0.65, 95% CI: 0.613-0.681), was developed. It was validated internally using a bootstrap method. In predicting 1-year survival for death alone, our 8-predictor model had an AUC of 0.63 (95% CI: 0.579-0.678) while the 14-predictor Seattle model had an AUC of 0.72. The Seattle model did not report stroke | ||
| 520 | |a CONCLUSIONS: This novel prognostic model predicts the overall risk of ischemic stroke or death for HF patients. This model compares favorably for death with the Seattle model and has the added utility of including stroke as an endpoint. Use of this model will help identify those patients in need of more intensive monitoring and therapy and may help identify appropriate populations for trials of new therapies | ||
| 520 | |a CLINICAL TRIAL REGISTRATION: http://www.Clinicatrials.govNCT00041938 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, U.S. Gov't, Non-P.H.S. | |
| 650 | 4 | |a Heart failure | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Risk factors | |
| 650 | 4 | |a Stroke | |
| 650 | 7 | |a Anticoagulants |2 NLM | |
| 650 | 7 | |a Warfarin |2 NLM | |
| 650 | 7 | |a 5Q7ZVV76EI |2 NLM | |
| 650 | 7 | |a Aspirin |2 NLM | |
| 650 | 7 | |a R16CO5Y76E |2 NLM | |
| 700 | 1 | |a Cheng, Bin |e verfasserin |4 aut | |
| 700 | 1 | |a Mann, Douglas L |e verfasserin |4 aut | |
| 700 | 1 | |a Thompson, John L P |e verfasserin |4 aut | |
| 700 | 1 | |a Sacco, Ralph L |e verfasserin |4 aut | |
| 700 | 1 | |a Buchsbaum, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Sanford, Alexandra |e verfasserin |4 aut | |
| 700 | 1 | |a Pullicino, Patrick M |e verfasserin |4 aut | |
| 700 | 1 | |a Levin, Bruce |e verfasserin |4 aut | |
| 700 | 1 | |a Teerlink, John R |e verfasserin |4 aut | |
| 700 | 1 | |a Graham, Susan |e verfasserin |4 aut | |
| 700 | 1 | |a Mohr, J P |e verfasserin |4 aut | |
| 700 | 1 | |a Labovitz, Arthur J |e verfasserin |4 aut | |
| 700 | 1 | |a Di Tullio, Marco R |e verfasserin |4 aut | |
| 700 | 1 | |a Lip, Gregory Y H |e verfasserin |4 aut | |
| 700 | 1 | |a Estol, Conrado J |e verfasserin |4 aut | |
| 700 | 1 | |a Lok, Dirk J |e verfasserin |4 aut | |
| 700 | 1 | |a Ponikowski, Piotr |e verfasserin |4 aut | |
| 700 | 1 | |a Anker, Stefan D |e verfasserin |4 aut | |
| 700 | 1 | |a Homma, Shunichi |e verfasserin |4 aut | |
| 700 | 0 | |a WARCEF Investigators |e verfasserin |4 aut | |
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