Validation of Seattle Heart Failure Model for mortality risk prediction in patients treated with cardiac resynchronization therapy

François Regoli, Francesca Scopigni, Francisco Leyva, Maurizio Landolina, Stefano Ghio, Massimo Tritto, Leonardo Calò, Catherine Klersy, Angelo Auricchio

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

AimsSurvival prediction by the Seattle Heart Failure Model (SHFM) of patients treated with cardiac resynchronization therapy (CRT) remains ill defined. The performance of the SHFM in this clinical setting was therefore evaluated.Methods and resultsData from 1309 consecutive CRT patients (five centres) were collected retrospectively; 1139 of these patients were considered for analysis. Three-hundred and seven deaths occurred over 40.1 months (interquartile range 25.2-60.0 months; mean event rate 9.7%/year; survival of 89, 81, and 64% at 1, 2, and 5 years). Kaplan-Meier event-free survival analysis stratified according to tertile of SHFM score was significant (log rank test P <0.001). High-risk tertile (T1) survival was 82, 67, and 46% at 1, 2, and 5 years, respectively. Observed compared with SHFM-predicted survival was 0.11 vs. 0.08, 0.19 vs. 0.16, and 0.36 vs. 0.36, at 1, 2, and 5 years. Model discrimination by c-statistic was 0.64; the logistic models' area under the receiver operating characteristic curve (AUC-ROC) of risk tertiles was 0.66, 0.68, and 0.67, at 1, 2, and 5 years. Compared with the other two groups, T1 was globally more compromised. Within the T1 group, independent predictors of death were male gender, ischaemic heart failure aetiology, lower body weight, and CRT pacemaker.ConclusionsSHFM performance was found to be modest, tending to overestimate survival. However, SHFM identified a high-risk, globally more compromised patient subgroup, hence supporting a comprehensive approach, which should include nutritional, metabolic, and immunological aspects, as well as defibrillator back-up.

Original languageEnglish
Pages (from-to)211-220
Number of pages10
JournalEuropean Journal of Heart Failure
Volume15
Issue number2
DOIs
Publication statusPublished - Feb 2013

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Cardiac Resynchronization Therapy
Heart Failure
Mortality
Survival
ROC Curve
Defibrillators
Survival Analysis
Disease-Free Survival
Area Under Curve
Logistic Models
Body Weight

Keywords

  • Cardiac resynchronization therapy
  • Death
  • Heart failure
  • Prediction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Validation of Seattle Heart Failure Model for mortality risk prediction in patients treated with cardiac resynchronization therapy. / Regoli, François; Scopigni, Francesca; Leyva, Francisco; Landolina, Maurizio; Ghio, Stefano; Tritto, Massimo; Calò, Leonardo; Klersy, Catherine; Auricchio, Angelo.

In: European Journal of Heart Failure, Vol. 15, No. 2, 02.2013, p. 211-220.

Research output: Contribution to journalArticle

Regoli, François ; Scopigni, Francesca ; Leyva, Francisco ; Landolina, Maurizio ; Ghio, Stefano ; Tritto, Massimo ; Calò, Leonardo ; Klersy, Catherine ; Auricchio, Angelo. / Validation of Seattle Heart Failure Model for mortality risk prediction in patients treated with cardiac resynchronization therapy. In: European Journal of Heart Failure. 2013 ; Vol. 15, No. 2. pp. 211-220.
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abstract = "AimsSurvival prediction by the Seattle Heart Failure Model (SHFM) of patients treated with cardiac resynchronization therapy (CRT) remains ill defined. The performance of the SHFM in this clinical setting was therefore evaluated.Methods and resultsData from 1309 consecutive CRT patients (five centres) were collected retrospectively; 1139 of these patients were considered for analysis. Three-hundred and seven deaths occurred over 40.1 months (interquartile range 25.2-60.0 months; mean event rate 9.7{\%}/year; survival of 89, 81, and 64{\%} at 1, 2, and 5 years). Kaplan-Meier event-free survival analysis stratified according to tertile of SHFM score was significant (log rank test P <0.001). High-risk tertile (T1) survival was 82, 67, and 46{\%} at 1, 2, and 5 years, respectively. Observed compared with SHFM-predicted survival was 0.11 vs. 0.08, 0.19 vs. 0.16, and 0.36 vs. 0.36, at 1, 2, and 5 years. Model discrimination by c-statistic was 0.64; the logistic models' area under the receiver operating characteristic curve (AUC-ROC) of risk tertiles was 0.66, 0.68, and 0.67, at 1, 2, and 5 years. Compared with the other two groups, T1 was globally more compromised. Within the T1 group, independent predictors of death were male gender, ischaemic heart failure aetiology, lower body weight, and CRT pacemaker.ConclusionsSHFM performance was found to be modest, tending to overestimate survival. However, SHFM identified a high-risk, globally more compromised patient subgroup, hence supporting a comprehensive approach, which should include nutritional, metabolic, and immunological aspects, as well as defibrillator back-up.",
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AU - Regoli, François

AU - Scopigni, Francesca

AU - Leyva, Francisco

AU - Landolina, Maurizio

AU - Ghio, Stefano

AU - Tritto, Massimo

AU - Calò, Leonardo

AU - Klersy, Catherine

AU - Auricchio, Angelo

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N2 - AimsSurvival prediction by the Seattle Heart Failure Model (SHFM) of patients treated with cardiac resynchronization therapy (CRT) remains ill defined. The performance of the SHFM in this clinical setting was therefore evaluated.Methods and resultsData from 1309 consecutive CRT patients (five centres) were collected retrospectively; 1139 of these patients were considered for analysis. Three-hundred and seven deaths occurred over 40.1 months (interquartile range 25.2-60.0 months; mean event rate 9.7%/year; survival of 89, 81, and 64% at 1, 2, and 5 years). Kaplan-Meier event-free survival analysis stratified according to tertile of SHFM score was significant (log rank test P <0.001). High-risk tertile (T1) survival was 82, 67, and 46% at 1, 2, and 5 years, respectively. Observed compared with SHFM-predicted survival was 0.11 vs. 0.08, 0.19 vs. 0.16, and 0.36 vs. 0.36, at 1, 2, and 5 years. Model discrimination by c-statistic was 0.64; the logistic models' area under the receiver operating characteristic curve (AUC-ROC) of risk tertiles was 0.66, 0.68, and 0.67, at 1, 2, and 5 years. Compared with the other two groups, T1 was globally more compromised. Within the T1 group, independent predictors of death were male gender, ischaemic heart failure aetiology, lower body weight, and CRT pacemaker.ConclusionsSHFM performance was found to be modest, tending to overestimate survival. However, SHFM identified a high-risk, globally more compromised patient subgroup, hence supporting a comprehensive approach, which should include nutritional, metabolic, and immunological aspects, as well as defibrillator back-up.

AB - AimsSurvival prediction by the Seattle Heart Failure Model (SHFM) of patients treated with cardiac resynchronization therapy (CRT) remains ill defined. The performance of the SHFM in this clinical setting was therefore evaluated.Methods and resultsData from 1309 consecutive CRT patients (five centres) were collected retrospectively; 1139 of these patients were considered for analysis. Three-hundred and seven deaths occurred over 40.1 months (interquartile range 25.2-60.0 months; mean event rate 9.7%/year; survival of 89, 81, and 64% at 1, 2, and 5 years). Kaplan-Meier event-free survival analysis stratified according to tertile of SHFM score was significant (log rank test P <0.001). High-risk tertile (T1) survival was 82, 67, and 46% at 1, 2, and 5 years, respectively. Observed compared with SHFM-predicted survival was 0.11 vs. 0.08, 0.19 vs. 0.16, and 0.36 vs. 0.36, at 1, 2, and 5 years. Model discrimination by c-statistic was 0.64; the logistic models' area under the receiver operating characteristic curve (AUC-ROC) of risk tertiles was 0.66, 0.68, and 0.67, at 1, 2, and 5 years. Compared with the other two groups, T1 was globally more compromised. Within the T1 group, independent predictors of death were male gender, ischaemic heart failure aetiology, lower body weight, and CRT pacemaker.ConclusionsSHFM performance was found to be modest, tending to overestimate survival. However, SHFM identified a high-risk, globally more compromised patient subgroup, hence supporting a comprehensive approach, which should include nutritional, metabolic, and immunological aspects, as well as defibrillator back-up.

KW - Cardiac resynchronization therapy

KW - Death

KW - Heart failure

KW - Prediction

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