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Development of a Novel Heart Failure Risk Tool: The Barcelona Bio-Heart Failure Risk Calculator (BCN Bio-HF Calculator)
Lupón, Josep (Hospital Germans Trias i Pujol)
Antonio, Marta de (Hospital Germans Trias i Pujol)
Vila, Joan (Hospital del Mar. Institut Municipal d'Investigació Mèdica)
Peñafiel, Judith (Hospital del Mar. Institut Municipal d'Investigació Mèdica)
Galán, Amparo (Hospital Germans Trias i Pujol)
Zamora Serrallonga, Elisabet (Hospital Germans Trias i Pujol)
Urrutia de Diego, Agustín (Hospital Germans Trias i Pujol)
Bayés Genís, Antoni (Hospital Germans Trias i Pujol)

Date: 2014
Abstract: Background: A combination of clinical and routine laboratory data with biomarkers reflecting different pathophysiological pathways may help to refine risk stratification in heart failure (HF). A novel calculator (BCN Bio-HF calculator) incorporating N-terminal pro B-type natriuretic peptide (NT-proBNP, a marker of myocardial stretch), high-sensitivity cardiac troponin T (hs-cTnT, a marker of myocyte injury), and high-sensitivity soluble ST2 (ST2), (reflective of myocardial fibrosis and remodeling) was developed. Methods: Model performance was evaluated using discrimination, calibration, and reclassification tools for 1-, 2-, and 3-year mortality. Ten-fold cross-validation with 1000 bootstrapping was used. Results: The BCN Bio-HF calculator was derived from 864 consecutive outpatients (72% men) with mean age 68. 2±12 years (73%/27% New York Heart Association (NYHA) class I-II/III-IV, LVEF 36%, ischemic etiology 52. 2%) and followed for a median of 3. 4 years (305 deaths). After an initial evaluation of 23 variables, eight independent models were developed. The variables included in these models were age, sex, NYHA functional class, left ventricular ejection fraction, serum sodium, estimated glomerular filtration rate, hemoglobin, loop diuretic dose, β-blocker, Angiotensin converting enzyme inhibitor/Angiotensin-2 receptor blocker and statin treatments, and hs-cTnT, ST2, and NT-proBNP levels. The calculator may run with the availability of none, one, two, or the three biomarkers. The calculated risk of death was significantly changed by additive biomarker data. The average C-statistic in cross-validation analysis was 0. 79. Conclusions: A new HF risk-calculator that incorporates available biomarkers reflecting different pathophysiological pathways better allowed individual prediction of death at 1, 2, and 3 years.
Rights: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. Creative Commons
Language: Anglès.
Document: article ; recerca ; publishedVersion
Subject: Biomarkers ; Heart failure ; Etiology ; Life expectancy ; Statins ; Diuretics ; Hemoglobin ; Multivariate analysis
Published in: PloS one, Vol. 9, Issue 1 (January 2014) , p.e85466, ISSN 1932-6203

DOI: 10.1371/journal.pone.0085466
PMID: 24454874

8 p, 611.0 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (scientific output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles

 Record created 2015-10-13, last modified 2020-06-23

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