Heart failure & cardiomyopathiesDiagnostic or prognostic study
Prognostic Models for Mortality and Morbidity in Heart Failure With Preserved Ejection Fraction
- Prognostic study (model derivation and validation)
- derivation in DELIVER trial
- external validation in PARAGON-HF and I-PRESERVE trials
- Data analysed January 2023 to June 2023
- Online risk calculator created
Authors' conclusion
In this prognostic study, a robust prediction model for clinical outcomes in HFpEF was developed and validated using routinely collected variables. The model performed better than NT-proBNP level alone.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF) in the DELIVER (derivation), PARAGON-HF and I-PRESERVE (validation) trials6,263 derivation
- Comparison
- New 11-variable prediction model vs Meta-Analysis Global Group in Chronic (MAGGIC) risk score, N-terminal pro-brain natriuretic peptide (NT-proBNP) alone and biomarker-driven model
- Outcome
- Composite of:
- HF hospitalization or CV death
- CV death
- All-cause death
- Follow-up
- 1 and 2 years
Performance
As reported in the abstract
Composite of HF hospitalization or CV death: discrimination · 1 year
New model
0.73
C statistic · 95% CI 0.71–0.75
MAGGIC
0.60
C statistic · 95% CI 0.58–0.63
NT-proBNP alone
0.66
C statistic · 95% CI 0.64–0.68
- New model vs MAGGIC
- delta C statistic 0.13 (95% CI 0.10–0.15); P < 0.001
- New model vs NT-proBNP alone
- delta C statistic 0.07 (95% CI 0.05–0.08); P < 0.001
Further findings
All-cause and CV death models
- Models for all-cause and CV death also performed well
Original publication
Prognostic Models for Mortality and Morbidity in Heart Failure With Preserved Ejection Fraction. JAMA Cardiol. Published 1 May 2024. doi:10.1001/jamacardio.2024.0284
Summarised from the published abstract; every number is checked against it