用于心力衰竭和风险估计的PREDICT-HFpEF模型:FINEARTS-HF的二次分析
Kirsty McDowell1, Kieran F Docherty1, Ross T Campbell1
1School of Cardiovascular & Metabolic Health, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom.
JAMA cardiology
|March 5, 2025
概括
PREDICT-HFpEF模型准确地预测了心力衰竭的结果,其中包括保留喷射分数 (HFpEF) 患者. 在FINEARTS-HF试验中,Finerenone在所有风险级别中都显示出一致的益处.
科学领域:
- 心脏病学 心脏病学
- 临床试验 临床试验
- 药理学 药理学是指药理学的学科.
背景情况:
- 患有心力衰竭和保留射出分数 (HFpEF) 的患者有不同的风险,影响治疗疗效.
- 在HFpEF的死亡率和发病率的预后模型 (PREDICT-HFpEF) 旨在对这些患者的风险进行分层.
研究的目的:
- 在FINEARTS-HF试验中验证PREDICT-HFpEF模型.
- 为了评估与安慰剂相比,在HFpEF患者的不同风险层中,芬瑞诺的疗效.
主要方法:
- 在FINEARTS-HF试验中,6001名患有症状性HF和射出分数≥40%的成年患者随机分别接受了finerenone或安慰剂.
- 计算了PREDICT-HFpEF风险评分,并使用Harrell C统计学来评估其性能.
- 在风险五分位数中分析了芬瑞的治疗效应.
主要成果:
- 预测-HFpEF模型显示了良好的校准和歧视 (C统计数据范围从0.68到0.71).
- 与最低五分位数相比,最高风险五分位数的患者的复合结局风险高出8到10倍.
- 芬瑞在所有风险层提供了一致的相对风险降低,没有显著的相互作用 (主要结果P=0.24).
结论:
- PREDICT-HFpEF模型已被验证用于预测HFpEF患者的结果.
- 在这个人群中,费内伦的治疗益处与基线风险独立.
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