Selçuk Adabag1, Lisa Langsetmo2. 1. Division of Cardiology, Minneapolis VA Health Care System, Minneapolis, Minnesota; Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota. Electronic address: adaba001@umn.edu. 2. Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota.
Abstract
BACKGROUND:Sudden cardiac death (SCD) comprises 25% of deaths in patients with heart failure with preserved ejection fraction. OBJECTIVE: We sought to validate a SCD risk prediction model in patients who participated in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist Trial. METHODS: Of the 3445 Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone AntagonistTrial participants, 615 (18%) had data on all 6 variables-age, sex, history of myocardial infarction, history of diabetes mellitus, presence of bundle branch block on the electrocardiogram, and N-terminal pro-brain natriuretic peptide level-of the SCD risk prediction model. Those with a 5-year predicted risk of SCD ≥10% were categorized as high risk patients. RESULTS: Over a mean follow-up of 2.9 ± 1.3 years, there were 23 SCDs (3.7%) and 63 deaths from other causes (10.2%). The rate of mortality from SCD and other causes were 13 (95% confidence interval [CI] 9-19) and 35 (95% CI 28-45) per 1000 person-years of follow-up, respectively. A total of 216 participants (35.1%) were categorized as high risk by the SCD risk model. The estimated 5-year cumulative incidence of SCD was 15.2% (95% CI 6.6%-27.2%) in those classified as high risk vs 2.8% (95% CI 1.2%-5.5%) in those classified as low risk. In competing risk analysis, patients predicted to have high SCD risk had a 3.7-fold higher risk of SCD (hazard ratio 3.7; 95% CI 1.6-8.7; P = .003) than did those predicted to have low risk. The SCD risk model yielded a Harrell's C index of 0.74. CONCLUSION: A SCD risk prediction model including 6 widely available variables can identify patients with heart failure with preserved ejection fraction who had a high risk of SCD. Published by Elsevier Inc.
RCT Entities:
BACKGROUND:Sudden cardiac death (SCD) comprises 25% of deaths in patients with heart failure with preserved ejection fraction. OBJECTIVE: We sought to validate a SCD risk prediction model in patients who participated in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist Trial. METHODS: Of the 3445 Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist Trial participants, 615 (18%) had data on all 6 variables-age, sex, history of myocardial infarction, history of diabetes mellitus, presence of bundle branch block on the electrocardiogram, and N-terminal pro-brain natriuretic peptide level-of the SCD risk prediction model. Those with a 5-year predicted risk of SCD ≥10% were categorized as high risk patients. RESULTS: Over a mean follow-up of 2.9 ± 1.3 years, there were 23 SCDs (3.7%) and 63 deaths from other causes (10.2%). The rate of mortality from SCD and other causes were 13 (95% confidence interval [CI] 9-19) and 35 (95% CI 28-45) per 1000 person-years of follow-up, respectively. A total of 216 participants (35.1%) were categorized as high risk by the SCD risk model. The estimated 5-year cumulative incidence of SCD was 15.2% (95% CI 6.6%-27.2%) in those classified as high risk vs 2.8% (95% CI 1.2%-5.5%) in those classified as low risk. In competing risk analysis, patients predicted to have high SCD risk had a 3.7-fold higher risk of SCD (hazard ratio 3.7; 95% CI 1.6-8.7; P = .003) than did those predicted to have low risk. The SCD risk model yielded a Harrell's C index of 0.74. CONCLUSION: A SCD risk prediction model including 6 widely available variables can identify patients with heart failure with preserved ejection fraction who had a high risk of SCD. Published by Elsevier Inc.
Entities:
Keywords:
Heart failure; Mortality; Risk prediction; Sudden cardiac death
Authors: Mausam Patel; Daniela Rodriguez; Keyvan Yousefi; Krista John-Williams; Armando J Mendez; Ronald B Goldberg; Anastasios Lymperopoulos; Leonardo J Tamariz; Jeffrey J Goldberger; Robert J Myerburg; Juhani Junttila; Lina A Shehadeh Journal: Front Cardiovasc Med Date: 2020-11-30
Authors: Li Shen; Pardeep S Jhund; Inder S Anand; Peter E Carson; Akshay S Desai; Christopher B Granger; Lars Køber; Michel Komajda; Robert S McKelvie; Marc A Pfeffer; Scott D Solomon; Karl Swedberg; Michael R Zile; John J V McMurray Journal: Clin Res Cardiol Date: 2020-12-10 Impact factor: 5.460