Derivation and validation of a simple clinical risk-model in heart failure based on 6 minute walk test performance and NT-proBNP status – Do we need specificity for sex and beta-blockers?

Frankenstein, L., Goode, K., Ingle, L., Remppis, A., Schellberg, D., Nelles, M., Katus, H.A., Clark, A.L., Cleland, J.G.F. and Zugck, C. (2011) Derivation and validation of a simple clinical risk-model in heart failure based on 6 minute walk test performance and NT-proBNP status – Do we need specificity for sex and beta-blockers? International Journal of Cardiology, 147(1), pp. 74-78. (doi:10.1016/j.ijcard.2009.08.005) (PMID:19765836)

Full text not currently available from Enlighten.

Abstract

Background: It is unclear whether risk prediction strategies in chronic heart failure (CHF) need to be specific for sex or beta-blockers. We examined this problem and developed and validated the consequent risk models based on 6-minute-walk-test and NT-proBNP. Methods: The derivation cohort comprised 636 German patients with systolic dysfunction. They were validated against 676 British patients with similar aetiology. ROC-curves for 1-year mortality identified cut-off values separately for specificity (none, sex, beta-blocker, both). Patients were grouped according to number of cut-offs met (group I/II/III – 0/1/2 cut-offs). Results: Widest separation between groups was achieved with sex- and beta-blocker-specific cut offs. In the derivation population, 1-year mortality was 0%, 8%, 31% for group I, II and III, respectively. In the validation population, 1-year rates in the three risk groups were 2%, 7%, 14%, respectively, after application of the same cut-offs. Conclusion: Risk stratification for CHF should perhaps take sex and beta-blocker usage into account. We derived and independently validated relevant risk models based on 6-minute-walk-tests and NT-proBNP. Specifying sex and use of beta-blockers identified three distinct sub-groups with widely differing prognosis. In clinical practice, it may be appropriate to tailor the intensity of follow-up and/or the treatment strategy according to the risk-group.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John
Authors: Frankenstein, L., Goode, K., Ingle, L., Remppis, A., Schellberg, D., Nelles, M., Katus, H.A., Clark, A.L., Cleland, J.G.F., and Zugck, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:International Journal of Cardiology
Publisher:Elsevier
ISSN:0167-5273
ISSN (Online):1874-1754
Published Online:17 September 2009

University Staff: Request a correction | Enlighten Editors: Update this record