PMID- 24281135
OWN - NLM
STAT- MEDLINE
DCOM- 20140527
LR  - 20140122
IS  - 1941-3297 (Electronic)
IS  - 1941-3289 (Linking)
VI  - 7
IP  - 1
DP  - 2014 Jan
TI  - Four-variable risk model in men and women with heart failure.
PG  - 88-95
LID - 10.1161/CIRCHEARTFAILURE.113.000404 [doi]
AB  - BACKGROUND: Risk stratification is an integral component of clinical decision 
      making in heart failure (HF). Women with HF have unique characteristics compared 
      with men, and it is unknown whether common prognostic factors are equally useful 
      in both populations. We aimed to investigate whether sex-specific risk models are 
      more accurate for risk prediction in patients with advanced HF. METHODS AND 
      RESULTS: Patients with advanced HF referred to University of California, Los 
      Angeles (UCLA; n=2255), were stratified by sex into derivation (referred in 
      2000-2007) and validation (referred in 2008-2011) cohorts. Cox regression 
      analysis was used to ascertain key variables predictive of the primary end point 
      of death/urgent transplantation/ventricular assist device in the derivation 
      cohorts and confirmed in the validation cohorts in men, women, and the total 
      population. Women were younger, with higher ejection fraction and better 
      event-free survival. Despite differences in baseline characteristics, the 4 
      strongest predictors of outcome in both women and men, as well as in the total 
      cohort, were B-type natriuretic peptide, peak oxygen consumption by 
      cardiopulmonary exercise testing (pkVO2), New York Heart Association (NYHA) 
      classification, and use of angiotensin-converting enzyme inhibitor or angiotensin 
      receptor blocker. In addition, the UCLA model performed better than the Seattle 
      Heart Failure Model (SHFM) and the Heart Failure Survival Score (HFSS) in our 
      cohort (c-indices of 0.791[UCLA] versus 0.758 [SHFM], 0.607 [noninvasive HFSS], 
      and 0.625 [invasive HFSS]). CONCLUSIONS: A simple risk model assessing 4 clinical 
      variables-B-type natriuretic peptide, pkVO2, NYHA, and angiotensin-converting 
      enzyme inhibitor/angiotensin receptor blocker use-is well suited to provide 
      prognostic information in both men and women with advanced HF.
FAU - Chyu, Jennifer
AU  - Chyu J
AD  - Division of Cardiology, University of Washington, Seattle.
FAU - Fonarow, Gregg C
AU  - Fonarow GC
FAU - Tseng, Chi Hong
AU  - Tseng CH
FAU - Horwich, Tamara B
AU  - Horwich TB
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20131126
PL  - United States
TA  - Circ Heart Fail
JT  - Circulation. Heart failure
JID - 101479941
RN  - 0 (Angiotensin Receptor Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
CIN - Circ Heart Fail. 2014 Mar 1;7(2):380. PMID: 24643891
CIN - Circ Heart Fail. 2014 Mar 1;7(2):381. PMID: 24779055
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiotensin Receptor Antagonists/*therapeutic use
MH  - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use
MH  - Cohort Studies
MH  - Female
MH  - Heart Failure/classification/*mortality/*therapy
MH  - Heart Transplantation
MH  - Heart-Assist Devices
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - *Models, Cardiovascular
MH  - Natriuretic Peptide, Brain/*blood
MH  - Oxygen Consumption/*physiology
MH  - Prognosis
MH  - Regression Analysis
MH  - Risk Factors
MH  - Sex Factors
MH  - Survival Rate
MH  - Young Adult
OTO - NOTNLM
OT  - heart failure
OT  - men
OT  - prognosis
OT  - therapy
OT  - women
EDAT- 2013/11/28 06:00
MHDA- 2014/05/28 06:00
CRDT- 2013/11/28 06:00
PHST- 2013/11/28 06:00 [entrez]
PHST- 2013/11/28 06:00 [pubmed]
PHST- 2014/05/28 06:00 [medline]
AID - CIRCHEARTFAILURE.113.000404 [pii]
AID - 10.1161/CIRCHEARTFAILURE.113.000404 [doi]
PST - ppublish
SO  - Circ Heart Fail. 2014 Jan;7(1):88-95. doi: 10.1161/CIRCHEARTFAILURE.113.000404. 
      Epub 2013 Nov 26.