دورية أكاديمية
A heart failure phenotype stratified model for predicting 1-year mortality in patients admitted with acute heart failure: results from an individual participant data meta-analysis of four prospective European cohorts
| العنوان: | A heart failure phenotype stratified model for predicting 1-year mortality in patients admitted with acute heart failure: results from an individual participant data meta-analysis of four prospective European cohorts |
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| المؤلفون: | Chen, YT, Voors, AA, Jaarsma, T, Lang, CC, Sama, IE, Akkerhuis, Martijn, Boersma, Eric, Hillege, HL, Postmus, D |
| المصدر: | Chen , YT , Voors , AA , Jaarsma , T , Lang , CC , Sama , IE , Akkerhuis , M , Boersma , E , Hillege , HL & Postmus , D 2021 , ' A heart failure phenotype stratified model for predicting 1-year mortality in patients admitted with acute heart failure: results from an individual participant data meta-analysis of four prospective European cohorts ' , BMC Medicine , vol. 19 , no. 1 , 21 . https://doi.org/10.1186/s12916-020-01894-2Test |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | /dk/atira/pure/keywords/researchprograms/AFL001000/EMCCOEUR09, name=EMC COEUR-09, /dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being, name=SDG 3 - Good Health and Well-being |
| الوصف: | Background: Prognostic models developed in general cohorts with a mixture of heart failure (HF) phenotypes, though more widely applicable, are also likely to yield larger prediction errors in settings where the HF phenotypes have substantially different baseline mortality rates or different predictor-outcome associations. This study sought to use individual participant data meta-analysis to develop an HF phenotype stratified model for predicting 1-year mortality in patients admitted with acute HF. Methods: Four prospective European cohorts were used to develop an HF phenotype stratified model. Cox model with two rounds of backward elimination was used to derive the prognostic index. Weibull model was used to obtain the baseline hazard functions. The internal-external cross-validation (IECV) approach was used to evaluate the generalizability of the developed model in terms of discrimination and calibration. Results: 3577 acute HF patients were included, of which 2368 were classified as having HF with reduced ejection fraction (EF) (HFrEF; EF < 40%), 588 as having HF with midrange EF (HFmrEF; EF 40–49%), and 621 as having HF with preserved EF (HFpEF; EF ≥ 50%). A total of 11 readily available variables built up the prognostic index. For four of these predictor variables, namely systolic blood pressure, serum creatinine, myocardial infarction, and diabetes, the effect differed across the three HF phenotypes. With a weighted IECV-adjusted AUC of 0.79 (0.74–0.83) for HFrEF, 0.74 (0.70–0.79) for HFmrEF, and 0.74 (0.71–0.77) for HFpEF, the model showed excellent discrimination. Moreover, there was a good agreement between the average observed and predicted 1-year mortality risks, especially after recalibration of the baseline mortality risks. Conclusions: Our HF phenotype stratified model showed excellent generalizability across four European cohorts and may provide a useful tool in HF phenotype-specific clinical decision-making. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| العلاقة: | https://pure.eur.nl/en/publications/0ce070c3-8778-4791-81cf-d55c5db198c9Test |
| DOI: | 10.1186/s12916-020-01894-2 |
| الإتاحة: | https://doi.org/10.1186/s12916-020-01894-2Test https://pure.eur.nl/en/publications/0ce070c3-8778-4791-81cf-d55c5db198c9Test https://pure.eur.nl/ws/files/48433935/Repub_134219_O-A.pdfTest http://www.scopus.com/inward/record.url?scp=85099821435&partnerID=8YFLogxKTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.349CC223 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/s12916-020-01894-2 |
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