Meta-Analysis Global Group in Chronic (MAGGIC) Heart Failure Risk Score: Validation of a Simple Tool for the Prediction of Morbidity and Mortality in Heart Failure With Preserved Ejection Fraction.
Meta-Analysis Global Group in Chronic (MAGGIC) Heart Failure Risk Score: Validation of a Simple Tool for the Prediction of Morbidity and Mortality in Heart Failure With Preserved Ejection Fraction.
复制标题
慢性（MAGGIC）心力衰竭风险评分的荟萃分析全球组：验证一种简单的工具，用于预测心力衰竭的发病率和死亡率，并保留了射血分数。
DOI：
10.1161/jaha.118.009594
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发表时间：
2018-10-16
影响因子：
5.4
通讯作者：
Shah SJ
中科院分区：
文献类型：
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作者：
Rich JD;Burns J;Freed BH;Maurer MS;Burkhoff D;Shah SJ
Meta分析全球慢性心力衰竭组（MAGGIC）死亡风险评分来自射血分数（EF）范围内的心力衰竭（HF）患者的大样本，尚未在具有裁定发病结局的EF保留的良好特征的HF队列中进行外部验证。我们评估了407例EF保留的HF患者的MAGGIC风险评分（由13个临床变量组成），并使用考克斯回归来评估其与发病率/死亡率的相关性。我们使用受试者操作特征分析比较了MAGGIC风险评分与更复杂的西雅图心力衰竭模型的预测能力，并确定了将B型利钠肽添加到MAGGIC风险评分中进行风险预测的价值。在3.6±1.8年的平均随访时间内，28%死亡，32%因HF住院，55%因心血管住院和/或死亡。MAGGIC评分（平均值±SD为18±7）与死亡率（P<0.0001）、HF住院（P<0.0001）和心血管相关住院或死亡的联合终点显著相关（风险比，1.8 [95%置信区间，1.6-2.1]，MAGGIC评分每增加1-SD; P<0.0001）。受试者操作特征分析显示，MAGGIC和西雅图心力衰竭模型在预测EF结局保留的HF方面表现相似，但MAGGIC评分显示出对住院结局的更好校准。进一步的分析显示，B型利钠肽是预测结果的MAGGIC风险评分的附加因素（似然比检验P<0.01）。MAGGIC风险评分是一种简单而有效的方法，可对EF保留的HF患者的发病率和死亡率进行风险分层。URL：http://www.clinicaltrials.gov。唯一标识符：NCT 01030991。
The Meta‐Analysis Global Group in Chronic Heart Failure (MAGGIC) mortality risk score, derived from a large sample of patients with heart failure (HF) across the spectrum of ejection fraction (EF), has not yet been externally validated in a well‐characterized HF with preserved EF cohort with adjudicated morbidity outcomes. We evaluated the MAGGIC risk score (composed of 13 clinical variables) in 407 patients with HF with preserved EF enrolled in a prospective registry and used Cox regression to evaluate its association with morbidity/mortality. We used receiver‐operating characteristic analysis to compare the predictive ability of the MAGGIC risk score with the more complex Seattle Heart Failure Model, and we determined the value of adding B‐type natriuretic peptide to the MAGGIC risk score for risk prediction. During a mean follow‐up time of 3.6±1.8 years, 28% died, 32% were hospitalized for HF, and 55% had a cardiovascular hospitalization and/or death. The MAGGIC score, a mean±SD of 18±7, was significantly associated with mortality (P<0.0001), HF hospitalizations (P<0.0001), and the combined end point of cardiovascular‐related hospitalizations or death (hazard ratio, 1.8 [95% confidence interval, 1.6–2.1], per 1‐SD increase in the MAGGIC score; P<0.0001). Receiver‐operating characteristic analyses showed that MAGGIC and Seattle Heart Failure Model performed similarly in predicting HF with preserved EF outcomes, but the MAGGIC score demonstrated better calibration for hospitalization outcomes. Further analyses showed that B‐type natriuretic peptide was additive to the MAGGIC risk score for predicting outcomes (P<0.01 by likelihood ratio test). The MAGGIC risk score is a simple, yet powerful method of risk stratification for both morbidity and mortality in HF with preserved EF. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01030991.