You are here
Validation of the health ABC heart failure model for incident heart failure risk prediction: the Cardiovascular Health Study.
Tuesday,2012-11-06 12:19 America/Los_Angeles — eenright
| Title | Validation of the health ABC heart failure model for incident heart failure risk prediction: the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2010 |
| Authors | Kalogeropoulos, A, Psaty, BM, Vasan, RS, Georgiopoulou, V, Smith, AL, Smith, NL, Kritchevsky, SB, Wilson, PWF, Newman, AB, Harris, TB, Butler, J |
| Corporate/Institutional Authors | Cardiovascular Health Study, |
| Journal | Circ Heart Fail |
| Volume | 3 |
| Issue | 4 |
| Pagination | 495-502 |
| Date Published | 2010 Jul |
| ISSN | 1941-3297 |
| Keywords | Age Distribution, Aged, Aged, 80 and over, Cause of Death, Cohort Studies, Confidence Intervals, Disease Progression, Echocardiography, Doppler, Female, Heart Failure, Humans, Incidence, Male, Models, Statistical, Predictive Value of Tests, Prognosis, Severity of Illness Index, Sex Distribution, Survival Analysis, United States |
| Abstract | <p><b>BACKGROUND: </b>The recently developed and internally validated Health ABC HF model uses 9 routinely available clinical variables to determine incident heart failure risk. In this study, we sought to externally validate the Health ABC HF model.</p><p><b>METHODS AND RESULTS: </b>Observed 5-year incidence of heart failure, defined as first hospitalization for new-onset heart failure, was compared with 5-year risk estimates derived from the Health ABC HF model among participants without heart failure at baseline in the Cardiovascular Health Study. During follow-up, 400 of 5335 (7.5%) participants developed heart failure over 5 years versus 364 (6.8%) predicted by the Health ABC HF model (predicted-to-observed ratio, 0.90). Observed versus predicted 5-year heart failure probabilities were 3.2% versus 2.8%, 9.0% versus 7.0%, 15.9% versus 13.7%, and 24.6% versus 30.8% for the <5%, 5% to 10%, 10% to 20%, and >20% 5-year risk categories, respectively. The Hosmer-Lemeshow chi(2) was 14.72 (degrees of freedom, 10; P=0.14), and the C index was 0.74 (95% CI, 0.72 to 0.76). Calibration and discrimination demonstrated adequate performance across sex and race overall; however, risk was underestimated in white men, especially in the 5% to 10% risk category. Model performance was optimal when participants with normal left ventricular function at baseline were assessed separately. Performance was consistent across age groups. Analyses with death as a competing risk yielded similar results.</p><p><b>CONCLUSIONS: </b>The Health ABC HF model adequately predicted 5-year heart failure risk in a large community-based study, providing support for the external validity of the model. This tool may be used to identify individuals to whom to target heart failure prevention efforts.</p> |
| DOI | 10.1161/CIRCHEARTFAILURE.109.904300 |
| Alternate Journal | Circ Heart Fail |
| PubMed ID | 20427700 |
| PubMed Central ID | PMC3285297 |
| Grant List | N01 HC085086 / HC / NHLBI NIH HHS / United States N01 HC085081 / HC / NHLBI NIH HHS / United States U01 HL080295-04 / HL / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC075150 / HC / NHLBI NIH HHS / United States U01-HL080295 / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01 HC085083 / HC / NHLBI NIH HHS / United States U01 HL080295-01 / HL / NHLBI NIH HHS / United States N01 HC085085 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States U01 HL080295-03 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01 HC085082 / HC / NHLBI NIH HHS / United States N01 HC085080 / HC / NHLBI NIH HHS / United States UL1 RR025008-04 / RR / NCRR NIH HHS / United States UL1 RR025008-03 / RR / NCRR NIH HHS / United States N01 HC055222 / HC / NHLBI NIH HHS / United States N01-HC-55222 / HC / NHLBI NIH HHS / United States U01 HL080295-02 / HL / NHLBI NIH HHS / United States UL1 TR000454 / TR / NCATS NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01 HC085084 / HC / NHLBI NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States UL1-RR025008 / RR / NCRR NIH HHS / United States UL1 RR025008-05 / RR / NCRR NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States UL1 RR025008-02 / RR / NCRR NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC085079 / HC / NHLBI NIH HHS / United States UL1 RR025008 / RR / NCRR NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States P30 AG021332 / AG / NIA NIH HHS / United States UL1 RR025008-01 / RR / NCRR NIH HHS / United States |