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Predictors of mortality and morbidity in patients with chronic heart failure.
- Source :
-
European heart journal [Eur Heart J] 2006 Jan; Vol. 27 (1), pp. 65-75. Date of Electronic Publication: 2005 Oct 11. - Publication Year :
- 2006
-
Abstract
- Aims: We aimed to develop prognostic models for patients with chronic heart failure (CHF).<br />Methods and Results: We evaluated data from 7599 patients in the CHARM programme with CHF with and without left ventricular systolic dysfunction. Multi-variable Cox regression models were developed using baseline candidate variables to predict all-cause mortality (n=1831 deaths) and the composite of cardiovascular (CV) death and heart failure (HF) hospitalization (n=2460 patients with events). Final models included 21 predictor variables for CV death/HF hospitalization and for death. The three most powerful predictors were older age (beginning >60 years), diabetes, and lower left ventricular ejection fraction (EF) (beginning <45%). Other independent predictors that increased risk included higher NYHA class, cardiomegaly, prior HF hospitalization, male sex, lower body mass index, and lower diastolic blood pressure. The model accurately stratified actual 2-year mortality from 2.5 to 44% for the lowest to highest deciles of predicted risk.<br />Conclusion: In a large contemporary CHF population, including patients with preserved and decreased left ventricular systolic function, routine clinical variables can discriminate risk regardless of EF. Diabetes was found to be a surprisingly strong independent predictor. These models can stratify risk and help define how patient characteristics relate to clinical course.
Details
- Language :
- English
- ISSN :
- 0195-668X
- Volume :
- 27
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- European heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 16219658
- Full Text :
- https://doi.org/10.1093/eurheartj/ehi555