Incorporation of natriuretic peptides with clinical risk scores to predict heart failure among individuals with dysglycaemia

Autor: Muthiah Vaduganathan, Javed Butler, Duwayne L Willett, W.H. Wilson Tang, Brendan M. Everett, Eric D. Peterson, Darren K. McGuire, Muhammad Shahzeb Khan, Gregg C. Fonarow, Kershaw V. Patel, Ambarish Pandey, Vaishnavi Kannan, Matthew W. Segar, Thomas J. Wang
Rok vydání: 2021
Předmět:
Zdroj: European Journal of Heart Failure. 24:169-180
ISSN: 1879-0844
1388-9842
DOI: 10.1002/ejhf.2375
Popis: AIMS To evaluate the performance of the WATCH-DM risk score, a clinical risk score for heart failure (HF), in patients with dysglycaemia and in combination with natriuretic peptides (NPs). METHODS AND RESULTS Adults with diabetes/pre-diabetes free of HF at baseline from four cohort studies (ARIC, CHS, FHS, and MESA) were included. The machine learning- [WATCH-DM(ml)] and integer-based [WATCH-DM(i)] scores were used to estimate the 5-year risk of incident HF. Discrimination was assessed by Harrell's concordance index (C-index) and calibration by the Greenwood-Nam-D'Agostino (GND) statistic. Improvement in model performance with the addition of NP levels was assessed by C-index and continuous net reclassification improvement (NRI). Of the 8938 participants included, 3554 (39.8%) had diabetes and 432 (4.8%) developed HF within 5 years. The WATCH-DM(ml) and WATCH-DM(i) scores demonstrated high discrimination for predicting HF risk among individuals with dysglycaemia (C-indices = 0.80 and 0.71, respectively), with no evidence of miscalibration (GND P ≥0.10). The C-index of elevated NP levels alone for predicting incident HF among individuals with dysglycaemia was significantly higher among participants with low/intermediate (
Databáze: OpenAIRE
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