Incident heart failure prediction in the elderly: the health ABC heart failure score.
Incident heart failure prediction in the elderly: the health ABC heart failure score.
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DOI：
10.1161/circheartfailure.108.768457
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发表时间：
2008-07
期刊：
影响因子：
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通讯作者：
Health ABC Study
中科院分区：
文献类型：
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作者：
Butler J;Kalogeropoulos A;Georgiopoulou V;Belue R;Rodondi N;Garcia M;Bauer DC;Satterfield S;Smith AL;Vaccarino V;Newman AB;Harris TB;Wilson PW;Kritchevsky SB;Health ABC Study
尽管心力衰竭 (HF) 发病率不断上升且美国人口老龄化，但对于老年人群中的心力衰竭事件尚无经过验证的预测模型。我们试图开发一种新的老年人 5 年心力衰竭风险预测模型。使用比例风险模型来评估参加 Health ABC 研究的 2935 名没有基线心力衰竭的老年参与者（73.6±2.9 岁，47.9% 男性，58.6% 白人）的心力衰竭事件的独立预测因素，定义为新发心力衰竭住院治疗。通过引导开发并内部验证了预测方程，从而可以制定 5 年风险评分。在 6.5±1.8 年的随访期间，258 名参与者 (8.8%) 发生了心力衰竭。心力衰竭事件的独立预测因素包括年龄、冠心病史和吸烟史、基线收缩压和心率、血糖、肌酐和白蛋白水平以及左心室肥厚。 Health ABC HF 模型在推导数据集中的 c 统计量为 0.73，内部验证（乐观校正）为 0.72，且校准良好（拟合优度 χ2 6.24，p=0.621）。创建一个简单的评分来将心力衰竭风险预测为四个风险组，分别对应 <5%、5-10%、10-20% 和 >20% 5 年风险。这些组的实际 5 年心力衰竭发生率分别为 2.9%、5.7%、13.3% 和 36.8%。 Health ABC 心力衰竭预测模型使用常见的临床变量来预测老年人发生心力衰竭的风险，这种方法可用于针对高风险个体进行治疗。
Despite the rising heart failure (HF) incidence and aging United States population, there are no validated prediction models for incident HF in the elderly population. We sought to develop a new prediction model for 5-year risk of incident HF among older persons. Proportional hazards models were used to assess independent predictors of incident HF, defined as hospitalization for new onset HF, in 2935 elderly participants without baseline HF enrolled in the Health ABC study (73.6±2.9 years, 47.9% males, 58.6% whites). A prediction equation was developed and internally validated by bootstrapping, allowing the development of a 5-year risk score. Incident HF developed in 258 (8.8%) participants during 6.5±1.8 years of follow-up. Independent predictors of incident HF included age, history of coronary disease and smoking, baseline systolic blood pressure and heart rate, serum glucose, creatinine, and albumin levels, and left ventricular hypertrophy. The Health ABC HF model had a c-statistic 0.73 in the derivation dataset, 0.72 by internal validation (optimism-corrected), and good calibration (goodness-of-fit χ2 6.24, p=0.621). A simple point score was created to predict incident HF risk into four risk groups corresponding to <5%, 5–10%, 10–20%, and >20% 5-yr risk. The actual 5-year incident HF rates in these groups were 2.9%, 5.7%, 13.3%, and 36.8% respectively. The Health ABC HF prediction model uses common clinical variables to predict incident HF risk in the elderly, an approach that may be used to target and treat high-risk individuals.