What question did this study set out to answer?

To develop and validate a prognostic model for predicting mortality and hospitalizations in chronic heart failure patients.

January 29, 2020JAMA CardiologyOpen Access

Prognostic Models Derived in PARADIGM-HF and Validated in ATMOSPHERE and the Swedish Heart Failure Registry to Predict Mortality and Morbidity in Chronic Heart Failure

Q: What does this research mean for the field?

A newly developed and externally validated prognostic model, incorporating NT-proBNP and other clinical variables, accurately predicts 1- and 2-year mortality and morbidity in patients with chronic heart failure. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Why the study?

Accurate prediction of risk of death or hospitalizations in heart failure could improve clinical decisions regarding disease-modifying treatments, advanced therapies, and end-of-life care.

Key Points

To develop and validate a prognostic model for predicting mortality and hospitalizations in chronic heart failure patients.
Multivariable analyses performed in a stepwise approach.
Validation using data from the ATMOSPHERE trial and Swedish Heart Failure Registry.
C statistic assessed discriminative ability for the model's predictions.
C statistic for primary composite endpoint was 0.74 (95% CI, 0.71-0.76) at 1 year and 0.71 (95% CI, 0.70-0.73) at 2 years.
1546 deaths and 2031 cardiovascular deaths or HF hospitalizations recorded over a mean follow-up of 27 months.
N-terminal pro brain natriuretic peptide identified as the most powerful independent predictor of outcomes.

Structured PICO

Population

8,399 patients with chronic heart failure (derivation cohort from PARADIGM-HF), mean age 64, 78.2% men, 70.6% NYHA class II. Validated in ATMOSPHERE and SwedeHF cohorts.

Outcome

Cardiovascular death, all-cause mortality, and the composite of cardiovascular death or HF hospitalization at both 1 and 2 yearscomposite

A newly developed prognostic model incorporating clinical variables and NT-proBNP accurately predicts 1- and 2-year mortality and morbidity in patients with chronic heart failure.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

May aid risk stratification in chronic HF; leaves open clinical utility pending prospective validation.

Cite This Study

Simpson et al. (2020) studied this question.

synapsesocial.com/papers/6a1d49fb164c88e7165ddb02 https://doi.org/10.1001/jamacardio.2019.5850

Topics

HFrEF treatment Heart failure HFpEF management

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Prognostic Models Derived in PARADIGM-HF and Validated in ATMOSPHERE and the Swedish Heart Failure Registry to Predict Mortality and Morbidity in Chronic Heart Failure

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Prognostic Models Derived in PARADIGM-HF and Validated in ATMOSPHERE and the Swedish Heart Failure Registry to Predict Mortality and Morbidity in Chronic Heart Failure

Key Points

Structured PICO

Discussion

Implication

Cite This Study

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