Novel biomarker-driven prognostic models to predict morbidity and mortality in chronic heart failure: the EMPEROR-Reduced trial
Authors' conclusion
The combination of NT-proBNP and hs-cTnT with a small number of readily available clinical variables provides prognostic assessment for patients with HFrEF.
Study context
- Population
- Patients with chronic heart failure with reduced ejection fraction (HFrEF)
- Participants
- 3,730 patients
- Primary endpoint
- Composite of:
- HF hospitalization
- CV death (prognostic model)
- Follow-up
- Median 16 months
Methodological detailsprognostic model development, external validation in BIOSTAT-CHF
- Prognostic model development
- External validation in BIOSTAT-CHF
Primary result
As reported in the abstract
Primary outcome events
823
22%
Dominant predictors NT-proBNP and high-sensitivity cardiac troponin T (hs-cTnT), plus shorter time since last heart failure (HF) hospitalization, longer time since HF diagnosis, lower SBP, New York Heart Association (NYHA) III or IV, higher heart rate, peripheral oedema
all P < 0.001
Discrimination, c-statistic
0.73
Top 10th vs bottom 10th of risk event rate
>9 times higher
Further findings
All-cause and CV mortality risk model (4 variables)
- Deaths
- 515 (14%)
- CV deaths
- 389 (10%)
- Predictors NT-proBNP, hs-cTnT, NYHA III or IV, ischaemic aetiology
- all P < 0.001
- C-statistic for all-cause and CV mortality
- 0.69
Empagliflozin effect across risk levels
- Empagliflozin benefitted patients across risk levels for the primary outcome
External validation (BIOSTAT-CHF)
- Similar c-statistics achieved
Original publication
Summarised from the published abstract; every number is checked against it