Validation of the Health ABC Heart Failure Model for Incident Heart Failure Risk Prediction The Cardiovascular Health Study
Validation of the Health ABC Heart Failure Model for Incident Heart Failure Risk Prediction The Cardiovascular Health Study
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DOI：
10.1161/circheartfailure.109.904300
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发表时间：
2010-07-01
影响因子：
9.7
通讯作者：
Butler, Javed
中科院分区：
文献类型：
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作者：
Kalogeropoulos, Andreas;Psaty, Bruce M.;Butler, Javed
背景-最近开发和内部验证的健康ABC HF模型使用9个常规可用的临床变量来确定突发心力衰竭风险。在这项研究中，我们试图从外部验证健康ABC HF model.Methods和结果观察5年的心力衰竭发病率，定义为首次住院治疗新发心力衰竭，与5年的风险估计来自健康ABC HF模型之间的参与者在基线没有心力衰竭在心血管健康研究。在随访期间，5335名参与者中有400名（7.5%）在5年内发生了心力衰竭，而健康ABC HF模型预测为364名（6.8%）（预测与观察比率，0.90）。对于<5%、5%至10%、10%至20%和> 20%的5年风险类别，观察到的与预测的5年心力衰竭概率分别为3.2%与2.8%、9.0%与7.0%、15.9%与13.7%和24.6%与30.8%。Hosmer-Lemeshow chi（2）为14.72（自由度，10; P=0.14），C指数为0.74（95%CI，0.72 ~ 0.76）。校准和区分显示了跨性别和种族的充分性能;然而，白色男性的风险被低估，特别是在5%至10%的风险类别中。当基线时左心室功能正常的参与者被单独评估时，模型性能是最佳的。各年龄组的表现一致。与死亡作为竞争风险的分析产生了类似的results.Conclusions-The健康ABC HF模型充分预测5年的心力衰竭风险在一个大型的社区为基础的研究，提供支持的外部效度的模型。该工具可用于确定心力衰竭预防工作的目标人群。(Circ心力衰竭。2010;3：495-502.）
Background-The recently developed and internally validated Health ABC HF model uses 9 routinely available clinical variables to determine incident heart failure risk. In this study, we sought to externally validate the Health ABC HF model.Methods and Results-Observed 5-year incidence of heart failure, defined as first hospitalization for new-onset heart failure, was compared with 5-year risk estimates derived from the Health ABC HF model among participants without heart failure at baseline in the Cardiovascular Health Study. During follow-up, 400 of 5335 (7.5%) participants developed heart failure over 5 years versus 364 (6.8%) predicted by the Health ABC HF model (predicted-to-observed ratio, 0.90). Observed versus predicted 5-year heart failure probabilities were 3.2% versus 2.8%, 9.0% versus 7.0%, 15.9% versus 13.7%, and 24.6% versus 30.8% for the < 5%, 5% to 10%, 10% to 20%, and > 20% 5-year risk categories, respectively. The Hosmer-Lemeshow chi(2) was 14.72 (degrees of freedom, 10; P=0.14), and the C index was 0.74 (95% CI, 0.72 to 0.76). Calibration and discrimination demonstrated adequate performance across sex and race overall; however, risk was underestimated in white men, especially in the 5% to 10% risk category. Model performance was optimal when participants with normal left ventricular function at baseline were assessed separately. Performance was consistent across age groups. Analyses with death as a competing risk yielded similar results.Conclusions-The Health ABC HF model adequately predicted 5-year heart failure risk in a large community-based study, providing support for the external validity of the model. This tool may be used to identify individuals to whom to target heart failure prevention efforts. (Circ Heart Fail. 2010;3:495-502.)