Key result
Missing study text prevents determining Essen Stroke Risk Score predictive value in HFpEF.
Why the study?
HFpEF is associated with increased risks of stroke and adverse outcomes, but whether the Essen Stroke Risk Score could predict adjudicated clinical outcomes in this population was unknown.
Does the Essen Stroke Risk Score predict clinical outcomes in patients with HFpEF?
Does the Essen Stroke Risk Score predict clinical outcomes in patients with HFpEF?
The Essen Stroke Risk Score demonstrates modest discriminatory ability and better calibration than traditional CHADS2-based scores for predicting stroke and other adverse outcomes in patients with HFpEF.
Answers are grounded in this paper and cite their sources.
ESRS was associated with higher composite, stroke, and MI risks in HFpEF; leaves open its clinical utility pending prospective validation.
BACKGROUND: Heart failure (HF) with preserved ejection fraction (HFpEF) is associated with increased risks of stroke and other adverse outcomes. AIMS: This study sought to determine whether the Essen Stroke Risk Score (ESRS) could predict the risks of adjudicated clinical outcomes in patients with HFpEF from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial. METHODS: We evaluated associations of baseline ESRS with clinical outcomes by using the Cox proportional hazard model with competing risk regression. The diagnostic accuracy of the ESRS was assessed using the C-index and calibration data. RESULTS: Of 3,441 HFpEF patients with a mean follow-up of 3.3 years, the risk of stroke ranged from 0.32% per year at an ESRS of 1 to 2 points to 1.71% per year at a score of ≥6 points. Each point increase in ESRS was associated with increased risks of primary composite outcome (hazard ratios [HRs] = 1.31; 95% confidence intervals [CIs]: 1.23-1.40; C-index = 0.68), stroke (HR = 1.33 [95% CI: 1.16-1.53]; C-index = 0.68), myocardial infarction (HR = 1.60 [95% CI: 1.40-1.83]; C-index = 0.75), HF hospitalization (HR = 1.30 [95% CI: 1.20-1.41]; C-index = 0.71), any hospitalization (HR = 1.20, 95% CI: 1.15-1.26; C-index = 0.68), cardiovascular death (HR = 1.32 [95% CI: 1.20-1.44]; C-index = 0.68), and all-cause death (HR = 1.37, [95% CI: 1.28-1.48]; C-index = 0.68). The calibration curves showed that the ESRS had a better agreement between predicted and observed stroke risks compared with the R2CHADS2, CHADS2, or CHA2DS2-VASC stroke scores. CONCLUSION: The ESRS had modest discriminatory abilities for predicting stroke as well as other adverse outcomes including myocardial infarction, hospitalization, and death in HFpEF patients. ESRS might have better calibration performance than R2CHADS2, CHADS2, or CHA2DS2-VASC in HFpEF at high risk for stroke. CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov. Unique identifier: NCT00094302.
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Zhu et al. (2022) studied Heart Failure with Preserved Ejection Fraction. Essen Stroke Risk Score was evaluated. The predictive value of the Essen Stroke Risk Score for clinical outcomes in heart failure patients with preserved ejection fraction could not be extracted because the study text was not provided.
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