A multivariate model for predicting mortality in patients with heart failure and systolic dysfunction
A multivariate model for predicting mortality in patients with heart failure and systolic dysfunction
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DOI：
10.1016/j.amjmed.2003.09.035
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发表时间：
2004-03-01
影响因子：
5.9
通讯作者：
Yusuf, S
中科院分区：
文献类型：
--
作者：
Brophy, JM;Dagenais, GR;Yusuf, S
背景：心力衰竭是发病率和死亡率的主要原因，但没有基于现成临床变量的可靠模型来预测服用血管紧张素转换酶 (ACE) 抑制剂的患者的结果。方法：在参加洋地黄研究组试验的 6422 名射血分数降低（小于或等于至 45%），处于窦性心律，并且正在服用 ACE 抑制剂。然后在其余 2145 名患者中验证了该模型。 结果：衍生样本中 12 个月时的总死亡率为 11.2% (n = 480)，36 个月时为 29.9% (n = 1277)。射血分数较低、肾功能较差、心脏肥大、功能分级较差、心力衰竭体征或症状、血压较低和体重指数较低与 12 个月生存率降低相关。该模型对验证样本中的死亡率提供了良好的预测。相同的变量以及年龄和硝酸盐的基线使用也可预测 36 个月死亡率。结论：常规临床变量可用于预测接受 ACE 抑制剂治疗的心力衰竭和收缩功能障碍患者的短期和长期死亡率。 (C) 2004 年，Excerpta Medica Inc.
BACKGROUND: Heart failure is a leading cause of morbidity and mortality, but there are no reliable models based on readily available clinical variables to predict outcomes in patients taking angiotensin-converting enzyme (ACE) inhibitors.METHODS: A multivariate statistical model to predict mortality was developed in a random sample (n = 4277 patients [67%]) of the 6422 patients enrolled in the Digitalis Investigation Group trial who had a depressed ejection fraction (less than or equal to45%), were in sinus rhythm, and were taking ACE inhibitors. The model was then validated in the remaining 2145 patients.RESULTS: Total mortality in the derivation sample was 11.2% (n = 480) at 12 months and 29.9% (n = 1277) at 36 months. Lower ejection fraction, worse renal function, cardiomegaly, worse functional class, signs or symptoms of heart failure, lower blood pressure, and lower body mass index were associated with reduced 12-month survival. This model provided good predictions of mortality in the verification sample. The same variables, along with age and the baseline use of nitrates, were also predictive of 36-month mortality.CONCLUSION: Routine clinical variables can be used to predict short- and long-term mortality in patients with heart failure and systolic dysfunction who are treated with ACE inhibitors. (C) 2004 by Excerpta Medica Inc.