Derivation and validation of a simple clinical risk-model in heart failure based on 6 minute walk test performance and NT-proBNP status - Do we need specificity for sex and beta-blockers?
Katus, H.A.; Cleland, J.G.F.; Frankenstein, L.; Goode, K.; Clark, A.L.; Ingle, Lee; Ingle, Lee; Remppis, A.; Schellberg, D.; Nelles, M.; Katus, H. A.; Clark, A. L.; Cleland, J. G. F.; Zugck, C.
Dr Kevin Goode K.M.Goode@hull.ac.uk
Research Systems Project Manager / Business Analyst
A.L. Clark A.L.Clark@hull.ac.uk
H. A. Katus
A. L. Clark
J. G. F. Cleland
BACKGROUND It is unclear whether risk prediction strategies in chronic heart failure (CHF) need to be specific for sex or beta-blockers. We examined this problem and developed and validated the consequent risk models based on 6-minute-walk-test and NT-proBNP. METHODS The derivation cohort comprised 636 German patients with systolic dysfunction. They were validated against 676 British patients with similar aetiology. ROC-curves for 1-year mortality identified cut-off values separately for specificity (none, sex, beta-blocker, both). Patients were grouped according to number of cut-offs met (group I/II/III - 0/1/2 cut-offs). RESULTS Widest separation between groups was achieved with sex- and beta-blocker-specific cut offs. In the derivation population, 1-year mortality was 0%, 8%, 31% for group I, II and III, respectively. In the validation population, 1-year rates in the three risk groups were 2%, 7%, 14%, respectively, after application of the same cut-offs. CONCLUSION Risk stratification for CHF should perhaps take sex and beta-blocker usage into account. We derived and independently validated relevant risk models based on 6-minute-walk-tests and NT-proBNP. Specifying sex and use of beta-blockers identified three distinct sub-groups with widely differing prognosis. In clinical practice, it may be appropriate to tailor the intensity of follow-up and/or the treatment strategy according to the risk-group.
|Journal Article Type||Article|
|Publication Date||Feb 17, 2011|
|Journal||International journal of cardiology|
|Peer Reviewed||Peer Reviewed|
|APA6 Citation||Frankenstein, L., Goode, K., Ingle, L., Remppis, A., Schellberg, D., Nelles, M., …Zugck, C. (2011). Derivation and validation of a simple clinical risk-model in heart failure based on 6 minute walk test performance and NT-proBNP status - Do we need specificity for sex and beta-blockers?. International journal of cardiology, 147(1), 74-78. https://doi.org/10.1016/j.ijcard.2009.08.005|
|Keywords||Chronic heart failure; Risk prediction; Beta-blockers; Sex|
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