Heart failure & cardiomyopathies
Predicting Stroke in Heart Failure and Preserved Ejection Fraction Without Atrial Fibrillation
Authors' conclusion
A simple risk model can detect a subset of HF and preserved ejection fraction patients without AF who have a higher risk for stroke.
Study context
- Population
- Patients with heart failure (HF) and preserved EF without atrial fibrillation (AF) at baseline, enrolled in I-Preserve and PARAGON-HFwithout AF, of 8924 pooled
- Participants
- 5,126 patients
- Comparison
- Risk score tertiles
- Outcome
- Stroke; validation of a 3-variable risk model (previous stroke, insulin-treated DM, NT-proBNP)
- Follow-up
- Median 3.6 years
Methodological detailspooled analysis of the I-Preserve and PARAGON-HF trials, external validation, pooled trial dataset
- Pooled analysis of the I-Preserve and PARAGON-HF trials
- External validation
- Pooled trial dataset
Performance
As reported in the abstract
Stroke
Third tertile
17.7 per 1000 patient-years
Each group vs first tertileHazard ratio (95% CI)
Second tertile
1.78(1.17–2.71)
Third tertile
3.03(2.06–4.47)
- Stroke in patients without AF
- 190 (3.7%); 10.5 per 1000 patient-years
- Model discrimination, C index
- 0.81 (0.68-0.91)
Further findings
Stroke rate in patients with AF (comparison)
Per 1000 patient-years
- AF not receiving anticoagulation
- 20.7
- AF receiving anticoagulation
- 14.5
- Third tertile rate similar to these
Original publication
Predicting Stroke in Heart Failure and Preserved Ejection Fraction Without Atrial Fibrillation. Circ Heart Fail. Published 23 June 2023. doi:10.
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