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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
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Novel biomarker-driven prognostic models to predict morbidity and mortality in chronic heart failure: the
Stuart J Pocock1, João Pedro Ferreira2,3, John Gregson1
1Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.
European Heart Journal
|August 23, 2021
Summary
This study developed a prognostic tool for heart failure with reduced ejection fraction (HFrEF) using biomarkers N-terminal pro B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT). The tool accurately predicts adverse outcomes and mortality in HFrEF patients.
Area of Science:
- Cardiology
- Biomarkers
- Prognostic Modeling
Background:
- Heart failure with reduced ejection fraction (HFrEF) poses significant prognostic challenges.
- Existing prognostic tools may not fully capture risk in contemporary heart failure populations.
- Biomarkers like NT-proBNP and hs-cTnT show strong associations with adverse outcomes in HFrEF.
Purpose of the Study:
- To develop and validate a biomarker-driven prognostic tool for chronic HFrEF.
- To identify key clinical variables and biomarkers for predicting adverse events in HFrEF.
- To create a risk model applicable for routine clinical use.
Main Methods:
- Utilized data from the EMPEROR-Reduced trial, including 3730 patients.
- Developed multivariable Cox regression models using stepwise selection for composite outcomes and mortality.
- Included candidate variables such as NT-proBNP, hs-cTnT, NYHA class, heart rate, and edema.
Main Results:
- NT-proBNP and hs-cTnT were dominant predictors of HF hospitalization, cardiovascular death, and all-cause mortality.
- A risk score incorporating eight variables demonstrated good discrimination (c-statistic = 0.73) for the primary outcome.
- Mortality risk models also showed good discrimination (c-statistic = 0.69) and were validated externally.
Conclusions:
- A combination of NT-proBNP, hs-cTnT, and select clinical variables provides robust prognostic assessment for HFrEF patients.
- This predictive tool kit is simple and can be readily implemented in clinical practice.
- The findings support enhanced risk stratification for improved HFrEF management.
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