Validation of the 2014 European Society of Cardiology Sudden Cardiac Death Risk Prediction Model in Hypertrophic Cardiomyopathy in a Reference Center in South America
Abstract Sudden cardiac death (SCD) is a common cause of death in hypertrophic cardiomyopathy (HC). Our aim was to conduct an external and independent validation in South America of the 2014 European Society of Cardiology (ESC) SCD risk prediction model to identify patients requiring an implantable...
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| Veröffentlicht in: | The American journal of cardiology 2016-07, Vol.118 (1), p.121-126 |
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| creator | Fernández, Adrián, MD Quiroga, Alejandro, MD Ochoa, Juan Pablo, MD Mysuta, Mauricio, MD Casabé, J Horacio, MD, MD Biagetti, Marcelo, Ph.D Guevara, Eduardo, MD Favaloro, Liliana E., MD Fava, Agostina M., MD Galizio, Néstor, MD |
| description | Abstract Sudden cardiac death (SCD) is a common cause of death in hypertrophic cardiomyopathy (HC). Our aim was to conduct an external and independent validation in South America of the 2014 European Society of Cardiology (ESC) SCD risk prediction model to identify patients requiring an implantable cardioverter defibrillator (ICD). This study included 502 consecutive HC patients followed between March/1993 and December/2014. A combined endpoint of SCD or appropriate ICD therapy (AT) was assessed. For the quantitative estimation of individual 5-year SCD risk, we used the formula: 1–0.998exp(Prognostic index) . Our database also included the abnormal blood pressure response to exercise (ABPRE) as a risk marker. We analyzed the three categories of 5-year risk proposed by the ESC: low risk (LR) |
| doi_str_mv | 10.1016/j.amjcard.2016.04.021 |
| format | Article |
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Our aim was to conduct an external and independent validation in South America of the 2014 European Society of Cardiology (ESC) SCD risk prediction model to identify patients requiring an implantable cardioverter defibrillator (ICD). This study included 502 consecutive HC patients followed between March/1993 and December/2014. A combined endpoint of SCD or appropriate ICD therapy (AT) was assessed. For the quantitative estimation of individual 5-year SCD risk, we used the formula: 1–0.998exp(Prognostic index) . Our database also included the abnormal blood pressure response to exercise (ABPRE) as a risk marker. We analyzed the three categories of 5-year risk proposed by the ESC: low risk (LR) <4%; intermediate risk (IR) ≥4-<6 % and high risk (HR) ≥6 %. The LR group included 387 (77%) patients; the IR group 39 (8%); and the HR group 76 (15%). Fourteen patients (3%) had SCD/AT [LR: 0%; IR: 2 of 39 (5%) and HR: 12 of 76 (16%)]. In a ROC curve the new model proved to be an excellent predictor, since the area under the curve for the estimated risk is 0.925 (statistical C: 0.925; 95% confidence interval 0.8884 to 0.9539, p< 0.0001). In conclusion, the SCD risk prediction model in HC proposed by the 2014 ESC Guidelines was validated in our population, and represents an improvement compared with previous approaches. A larger multicenter, independent and external validation of the model with long term follow-up would be advisable.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2016.04.021</identifier><identifier>PMID: 27189816</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Blood pressure ; Cardiac arrhythmia ; Cardiology ; Cardiomyopathy ; Cardiomyopathy, Hypertrophic - complications ; Cardiomyopathy, Hypertrophic - mortality ; Cardiomyopathy, Hypertrophic - therapy ; Cardiovascular ; Death, Sudden, Cardiac - etiology ; Defibrillators ; Defibrillators, Implantable ; Disease prevention ; Electrocardiography ; Family medical history ; Female ; Hospitals ; Humans ; Male ; Metabolic disorders ; Middle Aged ; Mutation ; Neuromuscular diseases ; Population ; Predictive Value of Tests ; Retrospective Studies ; Risk Assessment ; Risk factors ; ROC Curve ; Society ; South America ; Studies ; Young Adult</subject><ispartof>The American journal of cardiology, 2016-07, Vol.118 (1), p.121-126</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Jul 1, 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c547t-7029cfc697250aea168e23d5816842c37989973b493da354a33d36bd5cb41c233</citedby><cites>FETCH-LOGICAL-c547t-7029cfc697250aea168e23d5816842c37989973b493da354a33d36bd5cb41c233</cites><orcidid>0000-0003-0788-4761 ; 0000-0002-8565-2811 ; 0000-0002-1546-0216 ; 0000-0002-4542-0012</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914916305021$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27189816$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fernández, Adrián, MD</creatorcontrib><creatorcontrib>Quiroga, Alejandro, MD</creatorcontrib><creatorcontrib>Ochoa, Juan Pablo, MD</creatorcontrib><creatorcontrib>Mysuta, Mauricio, MD</creatorcontrib><creatorcontrib>Casabé, J Horacio, MD, MD</creatorcontrib><creatorcontrib>Biagetti, Marcelo, Ph.D</creatorcontrib><creatorcontrib>Guevara, Eduardo, MD</creatorcontrib><creatorcontrib>Favaloro, Liliana E., MD</creatorcontrib><creatorcontrib>Fava, Agostina M., MD</creatorcontrib><creatorcontrib>Galizio, Néstor, MD</creatorcontrib><title>Validation of the 2014 European Society of Cardiology Sudden Cardiac Death Risk Prediction Model in Hypertrophic Cardiomyopathy in a Reference Center in South America</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Abstract Sudden cardiac death (SCD) is a common cause of death in hypertrophic cardiomyopathy (HC). Our aim was to conduct an external and independent validation in South America of the 2014 European Society of Cardiology (ESC) SCD risk prediction model to identify patients requiring an implantable cardioverter defibrillator (ICD). This study included 502 consecutive HC patients followed between March/1993 and December/2014. A combined endpoint of SCD or appropriate ICD therapy (AT) was assessed. For the quantitative estimation of individual 5-year SCD risk, we used the formula: 1–0.998exp(Prognostic index) . Our database also included the abnormal blood pressure response to exercise (ABPRE) as a risk marker. We analyzed the three categories of 5-year risk proposed by the ESC: low risk (LR) <4%; intermediate risk (IR) ≥4-<6 % and high risk (HR) ≥6 %. The LR group included 387 (77%) patients; the IR group 39 (8%); and the HR group 76 (15%). Fourteen patients (3%) had SCD/AT [LR: 0%; IR: 2 of 39 (5%) and HR: 12 of 76 (16%)]. In a ROC curve the new model proved to be an excellent predictor, since the area under the curve for the estimated risk is 0.925 (statistical C: 0.925; 95% confidence interval 0.8884 to 0.9539, p< 0.0001). In conclusion, the SCD risk prediction model in HC proposed by the 2014 ESC Guidelines was validated in our population, and represents an improvement compared with previous approaches. A larger multicenter, independent and external validation of the model with long term follow-up would be advisable.</description><subject>Adult</subject><subject>Aged</subject><subject>Blood pressure</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Cardiomyopathy</subject><subject>Cardiomyopathy, Hypertrophic - complications</subject><subject>Cardiomyopathy, Hypertrophic - mortality</subject><subject>Cardiomyopathy, Hypertrophic - therapy</subject><subject>Cardiovascular</subject><subject>Death, Sudden, Cardiac - etiology</subject><subject>Defibrillators</subject><subject>Defibrillators, Implantable</subject><subject>Disease prevention</subject><subject>Electrocardiography</subject><subject>Family medical history</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Male</subject><subject>Metabolic disorders</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>Neuromuscular diseases</subject><subject>Population</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk factors</subject><subject>ROC Curve</subject><subject>Society</subject><subject>South America</subject><subject>Studies</subject><subject>Young Adult</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFks9uEzEQxlcIREPhEUCWuHBJ8L9dry-gKrQUqQjUAFfLsSfE6e46tXeR9oX6nMySAFIvPVnj-eY3mvmmKF4yumCUVW93C9vunE1-wTFcULmgnD0qZqxWes40E4-LGaWUzzWT-qR4lvMOQ8bK6mlxwhWrdc2qWXH3wzbB2z7EjsQN6bdAkCfJ-ZDiHmxHVtEF6McpucRuITbx50hWg_fQHX6sIx_A9ltyHfIN-ZrAB_eH9zl6aEjoyOW4h9QjcBvckdKOcY8145S25Bo2kKBzQJbQ9ZCm31UckHnWQgrOPi-ebGyT4cXxPS2-X5x_W17Or758_LQ8u5q7Uqp-rijXbuMqrXhJLVhW1cCFL3HUWnInlK61VmIttfBWlNIK4UW19qVbS-a4EKfFmwN3n-LtALk3bcgOmsZ2EIdsWE1rxUql5MNSbMYVrRRF6et70l0cUoeDTCpdS7SoRlV5ULkUc06wMfsUWptGw6iZPDc7c_TcTJ4bKg16jnWvjvRh3YL_V_XXZBS8PwgAN_crQDIZPcVt-5DA9cbH8GCLd_cIrgkd-tLcwAj5_zQmc0PNajq86e6wOS0nwG92t9OP</recordid><startdate>20160701</startdate><enddate>20160701</enddate><creator>Fernández, Adrián, MD</creator><creator>Quiroga, Alejandro, MD</creator><creator>Ochoa, Juan Pablo, MD</creator><creator>Mysuta, Mauricio, MD</creator><creator>Casabé, J Horacio, MD, MD</creator><creator>Biagetti, Marcelo, Ph.D</creator><creator>Guevara, Eduardo, MD</creator><creator>Favaloro, Liliana E., MD</creator><creator>Fava, Agostina M., MD</creator><creator>Galizio, Néstor, MD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>7QO</scope><orcidid>https://orcid.org/0000-0003-0788-4761</orcidid><orcidid>https://orcid.org/0000-0002-8565-2811</orcidid><orcidid>https://orcid.org/0000-0002-1546-0216</orcidid><orcidid>https://orcid.org/0000-0002-4542-0012</orcidid></search><sort><creationdate>20160701</creationdate><title>Validation of the 2014 European Society of Cardiology Sudden Cardiac Death Risk Prediction Model in Hypertrophic Cardiomyopathy in a Reference Center in South America</title><author>Fernández, Adrián, MD ; Quiroga, Alejandro, MD ; Ochoa, Juan Pablo, MD ; Mysuta, Mauricio, MD ; Casabé, J Horacio, MD, MD ; Biagetti, Marcelo, Ph.D ; Guevara, Eduardo, MD ; Favaloro, Liliana E., MD ; Fava, Agostina M., MD ; Galizio, Néstor, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c547t-7029cfc697250aea168e23d5816842c37989973b493da354a33d36bd5cb41c233</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Blood pressure</topic><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Cardiomyopathy</topic><topic>Cardiomyopathy, Hypertrophic - complications</topic><topic>Cardiomyopathy, Hypertrophic - mortality</topic><topic>Cardiomyopathy, Hypertrophic - therapy</topic><topic>Cardiovascular</topic><topic>Death, Sudden, Cardiac - etiology</topic><topic>Defibrillators</topic><topic>Defibrillators, Implantable</topic><topic>Disease prevention</topic><topic>Electrocardiography</topic><topic>Family medical history</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Male</topic><topic>Metabolic disorders</topic><topic>Middle Aged</topic><topic>Mutation</topic><topic>Neuromuscular diseases</topic><topic>Population</topic><topic>Predictive Value of Tests</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk factors</topic><topic>ROC Curve</topic><topic>Society</topic><topic>South America</topic><topic>Studies</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fernández, Adrián, MD</creatorcontrib><creatorcontrib>Quiroga, Alejandro, MD</creatorcontrib><creatorcontrib>Ochoa, Juan Pablo, MD</creatorcontrib><creatorcontrib>Mysuta, Mauricio, MD</creatorcontrib><creatorcontrib>Casabé, J Horacio, MD, MD</creatorcontrib><creatorcontrib>Biagetti, Marcelo, Ph.D</creatorcontrib><creatorcontrib>Guevara, Eduardo, MD</creatorcontrib><creatorcontrib>Favaloro, Liliana E., MD</creatorcontrib><creatorcontrib>Fava, Agostina M., MD</creatorcontrib><creatorcontrib>Galizio, Néstor, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biochemistry Abstracts 1</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fernández, Adrián, MD</au><au>Quiroga, Alejandro, MD</au><au>Ochoa, Juan Pablo, MD</au><au>Mysuta, Mauricio, MD</au><au>Casabé, J Horacio, MD, MD</au><au>Biagetti, Marcelo, Ph.D</au><au>Guevara, Eduardo, MD</au><au>Favaloro, Liliana E., MD</au><au>Fava, Agostina M., MD</au><au>Galizio, Néstor, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Validation of the 2014 European Society of Cardiology Sudden Cardiac Death Risk Prediction Model in Hypertrophic Cardiomyopathy in a Reference Center in South America</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2016-07-01</date><risdate>2016</risdate><volume>118</volume><issue>1</issue><spage>121</spage><epage>126</epage><pages>121-126</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Abstract Sudden cardiac death (SCD) is a common cause of death in hypertrophic cardiomyopathy (HC). Our aim was to conduct an external and independent validation in South America of the 2014 European Society of Cardiology (ESC) SCD risk prediction model to identify patients requiring an implantable cardioverter defibrillator (ICD). This study included 502 consecutive HC patients followed between March/1993 and December/2014. A combined endpoint of SCD or appropriate ICD therapy (AT) was assessed. For the quantitative estimation of individual 5-year SCD risk, we used the formula: 1–0.998exp(Prognostic index) . Our database also included the abnormal blood pressure response to exercise (ABPRE) as a risk marker. We analyzed the three categories of 5-year risk proposed by the ESC: low risk (LR) <4%; intermediate risk (IR) ≥4-<6 % and high risk (HR) ≥6 %. The LR group included 387 (77%) patients; the IR group 39 (8%); and the HR group 76 (15%). Fourteen patients (3%) had SCD/AT [LR: 0%; IR: 2 of 39 (5%) and HR: 12 of 76 (16%)]. In a ROC curve the new model proved to be an excellent predictor, since the area under the curve for the estimated risk is 0.925 (statistical C: 0.925; 95% confidence interval 0.8884 to 0.9539, p< 0.0001). In conclusion, the SCD risk prediction model in HC proposed by the 2014 ESC Guidelines was validated in our population, and represents an improvement compared with previous approaches. A larger multicenter, independent and external validation of the model with long term follow-up would be advisable.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27189816</pmid><doi>10.1016/j.amjcard.2016.04.021</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-0788-4761</orcidid><orcidid>https://orcid.org/0000-0002-8565-2811</orcidid><orcidid>https://orcid.org/0000-0002-1546-0216</orcidid><orcidid>https://orcid.org/0000-0002-4542-0012</orcidid></addata></record> |
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| subjects | Adult Aged Blood pressure Cardiac arrhythmia Cardiology Cardiomyopathy Cardiomyopathy, Hypertrophic - complications Cardiomyopathy, Hypertrophic - mortality Cardiomyopathy, Hypertrophic - therapy Cardiovascular Death, Sudden, Cardiac - etiology Defibrillators Defibrillators, Implantable Disease prevention Electrocardiography Family medical history Female Hospitals Humans Male Metabolic disorders Middle Aged Mutation Neuromuscular diseases Population Predictive Value of Tests Retrospective Studies Risk Assessment Risk factors ROC Curve Society South America Studies Young Adult |
| title | Validation of the 2014 European Society of Cardiology Sudden Cardiac Death Risk Prediction Model in Hypertrophic Cardiomyopathy in a Reference Center in South America |
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