Development and validation of a risk prediction model in patients with adult congenital heart disease

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023884%3A_____%2F19%3A00007859" target="_blank" >RIV/00023884:_____/19:00007859 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00064203:_____/19:10394227

Výsledek na webu

<a href="https://www.sciencedirect.com/science/article/abs/pii/S0167527318339536?via%3Dihub" target="_blank" >https://www.sciencedirect.com/science/article/abs/pii/S0167527318339536?via%3Dihub</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.ijcard.2018.08.059" target="_blank" >10.1016/j.ijcard.2018.08.059</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Development and validation of a risk prediction model in patients with adult congenital heart disease

Popis výsledku v původním jazyce

Aims To develop and validate a clinically useful risk prediction tool for patients with adult congenital heart disease (ACHD). Methods and results A risk model was developed in a prospective cohort of 602 patients with moderate/complex ACHD who routinely visited the outpatient clinic of a tertiary care centre in the Netherlands (2011−2013). This model was externally validated in a retrospective cohort of 402 ACHD patients (Czech Republic, 2004–2013). The primary endpoint was the 4-year risk of death, heart failure, or arrhythmia, which occurred in 135 of 602 patients (22%). Model development was performed using multivariable logistic regression. Model performance was assessed with C-statistics and calibration plots. Of the 14 variables that were selected by an expert panel, the final prediction model included age (OR 1.02, 95%CI 1.00–1.03, p = 0.031), congenital diagnosis (OR 1.52, 95%CI 1.03–2.23, p = 0.034), NYHA class (OR 1.74, 95%CI 1.07–2.84, p = 0.026), cardiac medication (OR 2.27, 95%CI 1.56–3.31, p < 0.001), re-intervention (OR 1.41, 95%CI 0.99–2.01, p = 0.060), BMI (OR 1.03, 95%CI 0.99–1.07, p = 0.123), and NT-proBNP (OR 1.63, 95%CI 1.45–1.84, p < 0.001). Calibration-in-the-large was suboptimal, reflected by a lower observed event rate in the validation cohort (17%) than predicted (36%), likely explained by heterogeneity and different treatment strategies. The externally validated C-statistic was 0.78 (95%CI 0.72–0.83), indicating good discriminative ability. Conclusion The proposed ACHD risk score combines six readily available clinical characteristics and NT-proBNP. This tool is easy to use and can aid in distinguishing high- and low-risk patients, which could further streamline counselling, location of care, and treatment in ACHD.

Název v anglickém jazyce

Development and validation of a risk prediction model in patients with adult congenital heart disease

Popis výsledku anglicky

Aims To develop and validate a clinically useful risk prediction tool for patients with adult congenital heart disease (ACHD). Methods and results A risk model was developed in a prospective cohort of 602 patients with moderate/complex ACHD who routinely visited the outpatient clinic of a tertiary care centre in the Netherlands (2011−2013). This model was externally validated in a retrospective cohort of 402 ACHD patients (Czech Republic, 2004–2013). The primary endpoint was the 4-year risk of death, heart failure, or arrhythmia, which occurred in 135 of 602 patients (22%). Model development was performed using multivariable logistic regression. Model performance was assessed with C-statistics and calibration plots. Of the 14 variables that were selected by an expert panel, the final prediction model included age (OR 1.02, 95%CI 1.00–1.03, p = 0.031), congenital diagnosis (OR 1.52, 95%CI 1.03–2.23, p = 0.034), NYHA class (OR 1.74, 95%CI 1.07–2.84, p = 0.026), cardiac medication (OR 2.27, 95%CI 1.56–3.31, p < 0.001), re-intervention (OR 1.41, 95%CI 0.99–2.01, p = 0.060), BMI (OR 1.03, 95%CI 0.99–1.07, p = 0.123), and NT-proBNP (OR 1.63, 95%CI 1.45–1.84, p < 0.001). Calibration-in-the-large was suboptimal, reflected by a lower observed event rate in the validation cohort (17%) than predicted (36%), likely explained by heterogeneity and different treatment strategies. The externally validated C-statistic was 0.78 (95%CI 0.72–0.83), indicating good discriminative ability. Conclusion The proposed ACHD risk score combines six readily available clinical characteristics and NT-proBNP. This tool is easy to use and can aid in distinguishing high- and low-risk patients, which could further streamline counselling, location of care, and treatment in ACHD.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2019

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

International Journal of Cardiology

ISSN

0167-5273

e-ISSN

—

Svazek periodika

276

Číslo periodika v rámci svazku

February

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

6

Strana od-do

87-92

Kód UT WoS článku

000454877900021

EID výsledku v databázi Scopus

2-s2.0-85054128640