Predicting Heart Failure in Patients with Atrial Fibrillation: A Report from the Prospective COOL-AF Registry.
Predicting Heart Failure in Patients with Atrial Fibrillation: A Report from the Prospective COOL-AF Registry.
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DOI：
10.3390/jcm12041265
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发表时间：
2023-02-06
影响因子：
3.9
通讯作者：
Lip, Gregory Y. H.
中科院分区：
文献类型：
--
作者：
Krittayaphong, Rungroj;Chichareon, Ply;Komoltri, Chulalak;Sairat, Poom;Lip, Gregory Y. H.
背景资料：本研究旨在确定亚洲房颤（AF）患者心力衰竭的危险因素和发生率，并建立一个预测风险模型。方法：这是一项2014年至2017年在泰国进行的非瓣膜性AF患者的前瞻性多中心登记研究。主要结局是HF事件的发生。使用多变量Cox比例模型开发预测模型。使用C指数、D统计量、校准图、Brier检验和生存分析评估预测模型。结果：共有3402例患者（平均年龄67.4岁，58.2%为男性），平均随访时间为25.7 ± 10.6个月。随访期间，218例患者发生心力衰竭，发生率为3.03（2.64-3.46）/100人-年。模型中有10个HF临床因素。从这些因素开发的预测模型的C指数和D统计量分别为0.756（95%CI：0.737-0.775）和1.503（95%CI：1.372-1.634）。校准图显示预测和观测模型之间的良好一致性，校准斜率为0.838。使用bootstrap方法确认内部验证。Brier评分表明该模型对HF具有良好的预测。结论：我们为AF患者提供了一个有效的临床HF预测模型，具有良好的预测和鉴别价值。
Background: This study aimed to determine risk factors and incidence rate and develop a predictive risk model for heart failure for Asian patients with atrial fibrillation (AF). Methods: This is a prospective multicenter registry of patients with non-valvular AF in Thailand conducted between 2014 and 2017. The primary outcome was the occurrence of an HF event. A predictive model was developed using a multivariable Cox-proportional model. The predictive model was assessed using C-index, D-statistics, Calibration plot, Brier test, and survival analysis. Results: There were a total of 3402 patients (average age 67.4 years, 58.2% male) with mean follow-up duration of 25.7 ± 10.6 months. Heart failure occurred in 218 patients during follow-up, representing an incidence rate of 3.03 (2.64–3.46) per 100 person-years. There were ten HF clinical factors in the model. The predictive model developed from these factors had a C-index and D-statistic of 0.756 (95% CI: 0.737–0.775) and 1.503 (95% CI: 1.372–1.634), respectively. The calibration plots showed a good agreement between the predicted and observed model with the calibration slope of 0.838. The internal validation was confirmed using the bootstrap method. The Brier score indicated that the model had a good prediction for HF. Conclusions: We provide a validated clinical HF predictive model for patients with AF, with good prediction and discrimination values.
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影响因子：
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通讯作者：
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