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A 13-item score based on readily available risk factors predicted risk for 3-year mortality in heart failure.
MedLine Citation:
PMID:  23318335     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
QUESTION Does an integer score based on readily available risk factors predict risk for mortality in patients with heart failure (HF) and reduced or preserved left ventricular ejection fraction (EF)? METHODS DESIGN Collaborative study using individual patient data from 30 cohort studies (median follow-up 2.5 y) participating in the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) program. {Eligible studies included patients with HF, did not have EF criterion for patient recruitment, and reported all-cause mortality}*. Missing data (range 0% for age and sex to 51% for creatinine level) were imputed using a multiple imputation algorithm. SETTING International, including Argentina, Denmark, France, Israel, Italy, Japan, New Zealand, North America, Spain, Sweden, and the UK. PATIENTS 39 372 patients (mean age 67 y, 67% men) who had HF with reduced or preserved left ventricular EF. DESCRIPTION OF PREDICTION GUIDE Risk score (Web-based risk calculator www.heartfailurerisk.org) included 13 variables: age (score varied with EF), sex, smoking status, body mass index, duration of HF, systolic blood pressure (score varied with EF), EF, New York Heart Association (NYHA) class, serum creatinine level, diabetes, chronic obstructive pulmonary disease, use of β-blockers, and use of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers. Maximum score is 57 points, and observed score range was 0 to 52 points. OUTCOME All-cause mortality. MAIN RESULTS 40% of patients died. Patients with higher risk scores had increased predicted and observed mortality at 3 years (Table). CONCLUSION A 13-item integer score based on readily available risk factors predicted risk for 3-year mortality in patients with heart failure and reduced or preserved ejection fraction.Predicted and observed risk for mortality by risk group in patients with heart failure†Risk group‡Number of patientsPredicted mortality at 3 y§Observed mortality at 3 y (95% CI)§1808311%8.8% (8.2 to 9.6)2716619%18% (17 to 19)3828328%27% (26 to 28)4720639%43% (41 to 44)5498053%55% (53 to 57)6365471%72% (70 to 73)†CI defined in Glossary.‡Risk groups are based on the first 4 quintiles (groups 1 to 4) and top 2 deciles (groups 5 and 6) of integer scores averaged across 25 imputed data sets; data sets were created using multiple imputation algorithms for missing data.§Data provided by author.
Authors:
Saurav Chatterjee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of internal medicine     Volume:  158     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  JC13     Citation Subset:  AIM; IM    
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