Performance of the MAGGIC heart failure risk score and its modification with the addition of discharge natriuretic peptides.
Performance of the MAGGIC heart failure risk score and its modification with the addition of discharge natriuretic peptides.
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DOI：
10.1002/ehf2.12278
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发表时间：
2018-08
影响因子：
3.8
通讯作者：
Yoshikawa T
中科院分区：
文献类型：
--
作者：
Sawano M;Shiraishi Y;Kohsaka S;Nagai T;Goda A;Mizuno A;Sujino Y;Nagatomo Y;Kohno T;Anzai T;Fukuda K;Yoshikawa T
心力衰竭患者的预测模型在临床实践中被广泛用于对患者的死亡率进行分层，并使临床医生能够定制和加强他们的方法。然而，这样的模型还没有在国际上得到验证。此外，现在经常测量生物标记物以获得预后信息，这种做法的含义尚不清楚。在这项研究中，我们旨在验证Meta分析全球慢性心力衰竭小组(MAGGIC)评分在日本急性心力衰竭登记中的模型性能，并进一步探索B型利钠肽(BNP)水平增加的预后价值。在这项研究中，我们评估了自2006年4月至2016年8月在日本进行的前瞻性多中心登记(东京西部心力衰竭)的2215名连续急性心力衰竭患者的登记数据(694至119人年随访)。平均年龄73.0岁±613.0岁，男性占61.2%。MAGGIC评分显示出中等的区分度(c指数=0.71，95%可信区间0.67~0.74)和良好的校准性(R2值=0.97)；对1年死亡率有持续的高估。然而，当将BNP水平添加到原始MAGGIC变量中时，该模型显示出良好的区分性(c-index=0.74，95%可信区间0.70-0.78)，并有足够的校正(R2值=100.91)。修改后的MAGGIC BNP评分在单独的日本注册中心(NaDEF)进行了外部验证，并显示出中等区分性(c-index=0.69，95%可信区间0.65-0.73)和校正(R2值=0.85)。最初的MAGGIC评分在日本患者中表现温和，但出院BNP水平的增加增强了模型的性能。客观生物标记物的加入可能导致对先前存在的国际公认的风险模型的有效修改，并有助于对心力衰竭患者的结果进行多国比较。
Predictive models for heart failure patients are widely used in the clinical practice to stratify patients' mortality and enable clinicians to tailor and intensify their approach. However, such models have not been validated internationally. In addition, biomarkers are now frequently measured to obtain prognostic information, and the implications of this practice are not known. In this study, we aimed to validate the model performance of the Meta‐analysis Global Group in Chronic Heart Failure (MAGGIC) score in a Japanese acute heart failure registry and further explore the incremental prognostic value of discharge B‐type natriuretic peptide (BNP) level. In this study, we evaluated the registered data of 2215 consecutive acute HF patients (with 694 119 person‐years follow‐up) from a prospective multicentre registry (the West Tokyo Heart Failure) conducted in Japan from April 2006 to August 2016. The mean age was 73.0 ± 13.0, and 61.2% were male. The MAGGIC score demonstrated modest discrimination (c‐index = 0.71, 95% confidence interval 0.67–0.74) and good calibration (R 2 value = 0.97); there was constant overestimation for 1 year mortality. However, when the BNP level was added to the original MAGGIC variables, the model demonstrated good discrimination (c‐index = 0.74, 95% confidence interval 0.70–0.78) with adequate calibration (R 2 value = 0.91). The modified MAGGIC BNP score was externally validated in a separate Japanese registry (NaDEF) and demonstrated moderate discrimination (c‐index = 0.69, 95% confidence interval 0.65–0.73) and calibration (R 2 value = 0.85). The original MAGGIC score performed modestly in Japanese patients, but the addition of discharge BNP level enhanced model performance. The addition of objective biomarkers may result in effective modification of preexisting internationally recognized risk models and aid in multinational comparisons of heart failure patients' outcomes.
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影响因子：
3.5
作者：
Lassus, Johan;Gayat, Etienne;Mebazaa, Alexandre
通讯作者：
Mebazaa, Alexandre
影响因子：
1.9
作者：
Guo, Yutao;Lip, Gregory Y. H.;Banerjee, Amitava
通讯作者：
Banerjee, Amitava
DOI：
10.1016/0735-1097(93)90455-a
发表时间：
1993-10-01
影响因子：
24
作者：
HO, KKL;PINSKY, JL;LEVY, D
通讯作者：
LEVY, D
DOI：
10.1161/circimaging.115.003754
发表时间：
2016-03
期刊：
Circulation. Cardiovascular imaging
影响因子：
--
作者：
Freed BH;Daruwalla V;Cheng JY;Aguilar FG;Beussink L;Choi A;Klein DA;Dixon D;Baldridge A;Rasmussen-Torvik LJ;Maganti K;Shah SJ
通讯作者：
Shah SJ
影响因子：
13
作者：
Malhotra, Rajeev;Bakken, Kristian;Lewis, Gregory D.
通讯作者：
Lewis, Gregory D.