PMID- 24454874
OWN - NLM
STAT- MEDLINE
DCOM- 20141229
LR  - 20211021
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 9
IP  - 1
DP  - 2014
TI  - Development of a novel heart failure risk tool: the barcelona bio-heart failure 
      risk calculator (BCN bio-HF calculator).
PG  - e85466
LID - 10.1371/journal.pone.0085466 [doi]
LID - e85466
AB  - BACKGROUND: A combination of clinical and routine laboratory data with biomarkers 
      reflecting different pathophysiological pathways may help to refine risk 
      stratification in heart failure (HF). A novel calculator (BCN Bio-HF calculator) 
      incorporating N-terminal pro B-type natriuretic peptide (NT-proBNP, a marker of 
      myocardial stretch), high-sensitivity cardiac troponin T (hs-cTnT, a marker of 
      myocyte injury), and high-sensitivity soluble ST2 (ST2), (reflective of 
      myocardial fibrosis and remodeling) was developed. METHODS: Model performance was 
      evaluated using discrimination, calibration, and reclassification tools for 1-, 
      2-, and 3-year mortality. Ten-fold cross-validation with 1000 bootstrapping was 
      used. RESULTS: The BCN Bio-HF calculator was derived from 864 consecutive 
      outpatients (72% men) with mean age 68.2 +/- 12 years (73%/27% New York Heart 
      Association (NYHA) class I-II/III-IV, LVEF 36%, ischemic etiology 52.2%) and 
      followed for a median of 3.4 years (305 deaths). After an initial evaluation of 
      23 variables, eight independent models were developed. The variables included in 
      these models were age, sex, NYHA functional class, left ventricular ejection 
      fraction, serum sodium, estimated glomerular filtration rate, hemoglobin, loop 
      diuretic dose, beta-blocker, Angiotensin converting enzyme inhibitor/Angiotensin-2 
      receptor blocker and statin treatments, and hs-cTnT, ST2, and NT-proBNP levels. 
      The calculator may run with the availability of none, one, two, or the three 
      biomarkers. The calculated risk of death was significantly changed by additive 
      biomarker data. The average C-statistic in cross-validation analysis was 0.79. 
      CONCLUSIONS: A new HF risk-calculator that incorporates available biomarkers 
      reflecting different pathophysiological pathways better allowed individual 
      prediction of death at 1, 2, and 3 years.
FAU - Lupon, Josep
AU  - Lupon J
AD  - Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain 
      ; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain.
FAU - de Antonio, Marta
AU  - de Antonio M
AD  - Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain 
      ; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain.
FAU - Vila, Joan
AU  - Vila J
AD  - IMIM (Hospital del Mar Medical Research Institute), Barcelona. Spain ; CIBER 
      Epidemiology and Public Health, Barcelona, Spain.
FAU - Penafiel, Judith
AU  - Penafiel J
AD  - IMIM (Hospital del Mar Medical Research Institute), Barcelona. Spain ; CIBER 
      Epidemiology and Public Health, Barcelona, Spain.
FAU - Galan, Amparo
AU  - Galan A
AD  - Biochemistry Service, Hospital Universitari Germans Trias i Pujol, Badalona, 
      Spain.
FAU - Zamora, Elisabet
AU  - Zamora E
AD  - Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain 
      ; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain.
FAU - Urrutia, Agustin
AU  - Urrutia A
AD  - Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain 
      ; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain.
FAU - Bayes-Genis, Antoni
AU  - Bayes-Genis A
AD  - Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain 
      ; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140115
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Aged
MH  - Female
MH  - Heart Failure/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Risk Assessment
PMC - PMC3893213
COIS- Competing Interests: For this study ST2 assays were performed by Critical 
      Diagnostics; hs-cTnT and NT-proBNP assays were provided by Roche Diagnostics, 
      which also provided a grant for statistical development and online application of 
      the calculator. Dr. A. Bayes-Genis has received lecture honoraria from Roche 
      Diagnostics and Critical Diagnostics and Dr. J. Lupon from Roche Diagnostics. Dr. 
      A. Bayes-Genis and Dr. J. Lupon have acquired stock shares of Critical 
      Diagnostics. The BCNBioHFCalculator has been registered by J. Lupon and A. 
      Bayes-Genis. There are no further patents, products in development or marketed 
      products to declare. This does not alter the authors' adherence to all the PLOS 
      ONE policies on sharing data and materials, as detailed online in the guide for 
      authors.
EDAT- 2014/01/24 06:00
MHDA- 2014/12/30 06:00
PMCR- 2014/01/15
CRDT- 2014/01/24 06:00
PHST- 2013/07/25 00:00 [received]
PHST- 2013/11/28 00:00 [accepted]
PHST- 2014/01/24 06:00 [entrez]
PHST- 2014/01/24 06:00 [pubmed]
PHST- 2014/12/30 06:00 [medline]
PHST- 2014/01/15 00:00 [pmc-release]
AID - PONE-D-13-30710 [pii]
AID - 10.1371/journal.pone.0085466 [doi]
PST - epublish
SO  - PLoS One. 2014 Jan 15;9(1):e85466. doi: 10.1371/journal.pone.0085466. eCollection 
      2014.