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Development and ext...
Development and external validation of prognostic models to predict sudden and pump-failure death in patients with HFrEF from PARADIGM-HF and ATMOSPHERE
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Shen, L. (author)
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Claggett, B. L. (author)
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Jhund, P. S. (author)
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Abraham, W. T. (author)
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Desai, A. S. (author)
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Dickstein, K. (author)
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Gong, J. J. (author)
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Kober, L. V. (author)
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Lefkowitz, M. P. (author)
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Rouleau, J. L. (author)
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Shi, V. C. (author)
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- Swedberg, Karl, 1944 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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Zile, M. R. (author)
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Solomon, S. D. (author)
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McMurray, J. J. V. (author)
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(creator_code:org_t)
- 2021-06-08
- 2021
- English.
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In: Clinical Research in Cardiology. - : Springer Science and Business Media LLC. - 1861-0684 .- 1861-0692. ; 110, s. 1334-1349
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https://link.springe...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
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- Background Sudden death (SD) and pump failure death (PFD) are the two leading causes of death in patients with heart failure and reduced ejection fraction (HFrEF). Objective Identifying patients at higher risk for mode-specific death would allow better targeting of individual patients for relevant device and other therapies. Methods We developed models in 7156 patients with HFrEF from the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure (PARADIGM-HF) trial, using Fine-Gray regressions counting other deaths as competing risks. The derived models were externally validated in the Aliskiren Trial to Minimize Outcomes in Patients with Heart Failure (ATMOSPHERE) trial. Results NYHA class and NT-proBNP were independent predictors for both modes of death. The SD model additionally included male sex, Asian or Black race, prior CABG or PCI, cancer history, MI history, treatment with LCZ696 vs. enalapril, QRS duration and ECG left ventricular hypertrophy. While LVEF, ischemic etiology, systolic blood pressure, HF duration, ECG bundle branch block, and serum albumin, chloride and creatinine were included in the PFD model. Model discrimination was good for SD and excellent for PFD with Harrell's C of 0.67 and 0.78 after correction for optimism, respectively. The observed and predicted incidences were similar in each quartile of risk scores at 3 years in each model. The performance of both models remained robust in ATMOSPHERE. Conclusion We developed and validated models which separately predict SD and PFD in patients with HFrEF. These models may help clinicians and patients consider therapies targeted at these modes of death.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Sudden death
- Pump failure death
- Model
- Risk
- Heart failure
- Device
- seattle heart-failure
- implantable cardioverter-defibrillator
- risk
- score
- proportional risk
- mortality
- survival
- outcomes
- morbidity
- enalapril
- Cardiovascular System & Cardiology
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Shen, L.
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Claggett, B. L.
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Jhund, P. S.
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Abraham, W. T.
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Desai, A. S.
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Dickstein, K.
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show more...
-
Gong, J. J.
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Kober, L. V.
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Lefkowitz, M. P.
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Rouleau, J. L.
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Shi, V. C.
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Swedberg, Karl, ...
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Zile, M. R.
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Solomon, S. D.
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McMurray, J. J. ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Clinical Researc ...
- By the university
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University of Gothenburg