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A novel age-biomarker-clinical history prognostic index for heart failure with reduced left ventricular ejection

Hao Li1, Yuan Cui1, Jin Tian2

  • 1Department of Health Statistics, Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, School of Public Health, Shanxi Medical University, 56 South XinJian Road, Taiyuan, Shanxi Province 030001, People's Republic of China.

Open Medicine (Warsaw, Poland)
|December 18, 2020
PubMed

Insights

A new prognostic index, the ABC-PI, effectively predicts outcomes for heart failure with reduced ejection fraction (HFrEF) patients. This tool utilizes age, biomarkers, and clinical history for personalized risk assessment.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Biostatistics

Background:

  • Heart failure with reduced left ventricular ejection fraction (HFrEF) lacks a validated prognostic model.
  • Accurate prognosis is crucial for guiding patient management and treatment strategies.

Purpose of the Study:

  • To develop and validate an Age-Biomarker-Clinical history Prognostic Index (ABC-PI) for predicting individual prognosis in HFrEF patients.
  • To assess the performance of the ABC-PI in stratifying mortality risk.

Main Methods:

  • Cox regression analysis identified significant predictors of all-cause mortality in 5,974 HFrEF patients (1,529 included).
  • Latent Trait Analysis (LTA) validated the discriminatory power of selected variables.
  • A nomogram was used to construct the ABC-PI, with scores ranging from 0-100.

Main Results:

  • Seven key variables were selected: age, N-terminal pro-B-type natriuretic peptide, renal dysfunction, left ventricular mass index, percutaneous coronary intervention, atrial fibrillation, and NYHA class (C-index: 0.801).
  • The ABC-PI demonstrated strong discrimination, with 3-year mortality rates of 34.7% in the high-risk group and 2.6% in the low-risk group.
  • The ABC-PI requires no re-input into original models, simplifying its application.

Conclusions:

  • The novel ABC-PI is a validated and effective tool for predicting prognosis in HFrEF patients.
  • The ABC-PI offers a practical and accurate method for individual risk stratification in clinical practice.
Abstract

Keywords:
HFrEFNT-proBNPlatent trait analysisnomogram

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