Predictive Accuracy of Heart Failure-Specific Risk Equations in an Electronic Health Record-Based Cohort.
Circ Heart Fail
; 13(11): e007462, 2020 11.
Article
em En
| MEDLINE
| ID: mdl-33092406
ABSTRACT
BACKGROUND:
Guidelines recommend identification of individuals at risk for heart failure (HF). However, implementation of risk-based prevention strategies requires validation of HF-specific risk scores in diverse, real-world cohorts. Therefore, our objective was to assess the predictive accuracy of the Pooled Cohort Equations to Prevent HF within a primary prevention cohort derived from the electronic health record.METHODS:
We retrospectively identified patients between the ages of 30 to 79 years in a multi-center integrated healthcare system, free of cardiovascular disease, with available data on HF risk factors, and at least 5 years of follow-up. We applied the Pooled Cohort Equations to Prevent HF tool to calculate sex and race-specific 5-year HF risk estimates. Incident HF was defined by the International Classification of Diseases codes. We assessed model discrimination and calibration, comparing predicted and observed rates for incident HF.RESULTS:
Among 31 256 eligible adults, mean age was 51.4 years, 57% were women and 11% Black. Incident HF occurred in 568 patients (1.8%) over 5-year follow-up. The modified Pooled Cohort Equations to Prevent HF model for 5-year risk prediction of HF had excellent discrimination in White men (C-statistic 0.82 [95% CI, 0.79-0.86]) and women (0.82 [0.78-0.87]) and adequate discrimination in Black men (0.69 [0.60-0.78]) and women (0.69 [0.52-0.76]). Calibration was fair in all race-sex subgroups (χ2<20).CONCLUSIONS:
A novel sex- and race-specific risk score predicts incident HF in a real-world, electronic health record-based cohort. Integration of HF risk into the electronic health record may allow for risk-based discussion, enhanced surveillance, and targeted preventive interventions to reduce the public health burden of HF.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Prevenção Primária
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Indicadores Básicos de Saúde
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Técnicas de Apoio para a Decisão
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Registros Eletrônicos de Saúde
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Insuficiência Cardíaca
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article