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The first prognostic model for stroke and death in patients with systolic heart failure.
Freudenberger, Ronald S; Cheng, Bin; Mann, Douglas L; Thompson, John L P; Sacco, Ralph L; Buchsbaum, Richard; Sanford, Alexandra; Pullicino, Patrick M; Levin, Bruce; Teerlink, John R; Graham, Susan; Mohr, J P; Labovitz, Arthur J; Di Tullio, Marco R; Lip, Gregory Y H; Estol, Conrado J; Lok, Dirk J; Ponikowski, Piotr; Anker, Stefan D; Homma, Shunichi.
Afiliação
  • Freudenberger RS; Lehigh Valley Health Network, Allentown, PA, USA; University of South Florida School of Medicine, Tampa, FL, USA. Electronic address: Ron.Freudenberger@gmail.com.
  • Cheng B; Columbia University Medical Center, New York, NY, USA.
  • Mann DL; Washington University, St. Louis, MO, USA.
  • Thompson JL; Columbia University Medical Center, New York, NY, USA.
  • Sacco RL; University of Miami, Miami, FL, USA.
  • Buchsbaum R; Columbia University Medical Center, New York, NY, USA.
  • Sanford A; Columbia University Medical Center, New York, NY, USA.
  • Pullicino PM; University of Kent, Canterbury, UK.
  • Levin B; Columbia University Medical Center, New York, NY, USA.
  • Teerlink JR; University of California - Medical School, San Francisco, CA, USA.
  • Graham S; State University of New York at Buffalo, Buffalo, NY, USA.
  • Mohr JP; Columbia University Medical Center, New York, NY, USA.
  • Labovitz AJ; University of South Florida School of Medicine, Tampa, FL, USA.
  • Di Tullio MR; Columbia University Medical Center, New York, NY, USA.
  • Lip GY; University of Birmingham Centre for Cardiovascular Sciences, Birmingham, UK.
  • Estol CJ; Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina.
  • Lok DJ; Hospital Deventer, Deventer, Netherlands.
  • Ponikowski P; Military Hospital, Wroclaw, Poland.
  • Anker SD; Center for Clinical and Basic Research, IRCCS San Raffaele, Rome, Italy.
  • Homma S; Columbia University Medical Center, New York, NY, USA.
J Cardiol ; 68(2): 100-3, 2016 08.
Article em En | MEDLINE | ID: mdl-26549533
BACKGROUND: Patients with systolic heart failure (HF) are at increased risk of both ischemic stroke and death. Currently, no risk scores are available to identify HF patients at high risk of stroke or death. The Warfarin vs. Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) trial studied 2305 HF patients, in sinus rhythm, followed for up to 6 years (3.5±1.5 years). This trial showed no overall difference in those treated with warfarin vs aspirin with regard to death or stroke. The present study develops the first prognostic model to identify patients at higher risk of stroke or death based on their overall risk profile. METHODS AND RESULTS: A scoring algorithm using 8 readily obtainable clinical characteristics as predictors, age, gender, hemoglobin, blood urea nitrogen, ejection fraction, diastolic blood pressure, diabetes status, and prior stroke or transient ischemic attack (C-index=0.65, 95% CI: 0.613-0.681), was developed. It was validated internally using a bootstrap method. In predicting 1-year survival for death alone, our 8-predictor model had an AUC of 0.63 (95% CI: 0.579-0.678) while the 14-predictor Seattle model had an AUC of 0.72. The Seattle model did not report stroke. CONCLUSIONS: This novel prognostic model predicts the overall risk of ischemic stroke or death for HF patients. This model compares favorably for death with the Seattle model and has the added utility of including stroke as an endpoint. Use of this model will help identify those patients in need of more intensive monitoring and therapy and may help identify appropriate populations for trials of new therapies. CLINICAL TRIAL REGISTRATION: http://www.Clinicatrials.govNCT00041938.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Modelos Estatísticos / Medição de Risco / Acidente Vascular Cerebral / Insuficiência Cardíaca Sistólica Tipo de estudo: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Modelos Estatísticos / Medição de Risco / Acidente Vascular Cerebral / Insuficiência Cardíaca Sistólica Tipo de estudo: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2016 Tipo de documento: Article