Heart failure & cardiomyopathiesCohort study
Predictors of 1-Year Mortality Among Patients With Heart Failure With Preserved Ejection Fraction
- retrospective cohort study
- development, comparison and internal validation of prediction models
- electronic medical records from a large academic health system
- training (80%) and test (20%) sets stratified by outcome
- multiple imputation by chained equations
Authors' conclusion
Our transparent risk tool using routinely available admission data appears feasible, allowing for patient-level, precision health risk assessment.
Study context
- Population
- Adults with ejection fraction (EF) ≥50% admitted for a first-time heart failure (HF) exacerbation
- Participants
- 7,840 admissions
- Exposure
- Prediction models for 1-year all-cause mortality after first hospitalization for decompensated HF with preserved EF, compared by AUROC, concordance index and calibration
Main finding
As reported in the abstract
One-year mortality · 1 year
One-year mortality
31.5%
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Test-set AUROC (classifiers) · acceptable calibration | Extreme Gradient Boosting AUROC 0.751 (95% CI 0.727–0.775) · Light Gradient Boosting AUROC 0.749 (95% CI 0.721–0.776) |
| Concordance index (survival models) · GBS achieved the highest concordance index | GBS concordance index 0.718 (95% CI 0.696–0.740) · RSF concordance index 0.711 (95% CI 0.690–0.734) · Cox concordance index 0.704 (95% CI 0.680–0.728) |
| Time-dependent AUROC (survival models) · 12 months | GBS time-dependent AUROC 0.759 (95% CI 0.716–0.799) · RSF time-dependent AUROC 0.750 (95% CI 0.708–0.789) · Cox time-dependent AUROC 0.735 (95% CI 0.692–0.777) |
Baseline characteristics
- mean age
- 78 years
- women
- 55.6%
Most consistent risk signals
- Lower albumin, older age, higher N-terminal pro-B-type natriuretic peptide, renal dysfunction, and lower hemoglobin were the most consistent risk signals
Original publication
Predictors of 1-Year Mortality Among Patients With Heart Failure With Preserved Ejection Fraction. JACC Adv. doi:10.1016/j.jacadv.2026.102847
Summarised from the published abstract; every number is checked against it