Predicting survival in heart failure: a risk score based on 39 372 patients from 30 studies

Pocock, S.J. et al. (2013) Predicting survival in heart failure: a risk score based on 39 372 patients from 30 studies. European Heart Journal, 34(19), pp. 1404-1413. (doi: 10.1093/eurheartj/ehs337)

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<p>Aims: Using a large international database from multiple cohort studies, the aim is to create a generalizable easily used risk score for mortality in patients with heart failure (HF).</p> <p>Methods and results The MAGGIC meta-analysis includes individual data on 39 372 patients with HF, both reduced and preserved left-ventricular ejection fraction (EF), from 30 cohort studies, six of which were clinical trials. 40.2% of patients died during a median follow-up of 2.5 years. Using multivariable piecewise Poisson regression methods with stepwise variable selection, a final model included 13 highly significant independent predictors of mortality in the following order of predictive strength: age, lower EF, NYHA class, serum creatinine, diabetes, not prescribed beta-blocker, lower systolic BP, lower body mass, time since diagnosis, current smoker, chronic obstructive pulmonary disease, male gender, and not prescribed ACE-inhibitor or angiotensin-receptor blockers. In preserved EF, age was more predictive and systolic BP was less predictive of mortality than in reduced EF. Conversion into an easy-to-use integer risk score identified a very marked gradient in risk, with 3-year mortality rates of 10 and 70% in the bottom quintile and top decile of risk, respectively.</p> <p>Conclusion In patients with HF of both reduced and preserved EF, the influences of readily available predictors of mortality can be quantified in an integer score accessible by an easy-to-use website The score has the potential for widespread implementation in a clinical setting.</p>

Item Type:Articles
Glasgow Author(s) Enlighten ID:McMurray, Professor John
Authors: Pocock, S.J., Ariti, C.A., McMurray, J.J.V., Maggioni, A., Kober, L., Squire, I.B., Swedberg, K., Dobson, J., Poppe, K.K., Whalley, G.A., and Doughty, R.N.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:European Heart Journal
Journal Abbr.:Eur. heart j.
ISSN (Online):1522-9645

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