Prediction of mode of death in heart failure : The seattle heart failure model
Prognosis and mode of death in heart failure patients are highly variable in that some patients die suddenly (often from ventricular arrhythmia) and others die of progressive failure of cardiac function (pump failure). Prediction of mode of death may facilitate decisions about specific medications o...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2007-07, Vol.116 (4), p.392-398 |
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| creator | MOZAFFARIAN, Dariush ANKER, Stefan D POOLE-WILSON, Philip A LEVY, Wayne C ANAND, Inder LINKER, David T SULLIVAN, Mark D CLELAND, John G. F CARSON, Peter E MAGGIONI, Aldo P MANN, Douglas L PITT, Bertram |
| description | Prognosis and mode of death in heart failure patients are highly variable in that some patients die suddenly (often from ventricular arrhythmia) and others die of progressive failure of cardiac function (pump failure). Prediction of mode of death may facilitate decisions about specific medications or devices.
We used the Seattle Heart Failure Model (SHFM), a validated prediction model for total mortality in heart failure, to assess the mode of death in 10,538 ambulatory patients with New York Heart Association class II to IV heart failure and predominantly systolic dysfunction enrolled in 6 randomized trials or registries. During 16,735 person-years of follow-up, 2014 deaths occurred, which included 1014 sudden deaths and 684 pump-failure deaths. Compared with a SHFM score of 0, patients with a score of 1 had a 50% higher risk of sudden death, patients with a score of 2 had a nearly 3-fold higher risk, and patients with a score of 3 or 4 had a nearly 7-fold higher risk (P |
| doi_str_mv | 10.1161/CIRCULATIONAHA.106.687103 |
| format | Article |
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We used the Seattle Heart Failure Model (SHFM), a validated prediction model for total mortality in heart failure, to assess the mode of death in 10,538 ambulatory patients with New York Heart Association class II to IV heart failure and predominantly systolic dysfunction enrolled in 6 randomized trials or registries. During 16,735 person-years of follow-up, 2014 deaths occurred, which included 1014 sudden deaths and 684 pump-failure deaths. Compared with a SHFM score of 0, patients with a score of 1 had a 50% higher risk of sudden death, patients with a score of 2 had a nearly 3-fold higher risk, and patients with a score of 3 or 4 had a nearly 7-fold higher risk (P<0.001 for all comparisons; 1-year area under the receiver operating curve, 0.68). Stratification of risk of pump-failure death was even more pronounced, with a 4-fold higher risk with a score of 1, a 15-fold higher risk with a score of 2, a 38-fold higher risk with a score of 3, and an 88-fold higher risk with a score of 4 (P<0.001 for all comparisons; 1-year area under the receiver operating curve, 0.85). The proportion of deaths caused by sudden death versus pump-failure death decreased from a ratio of 7:1 with a SHFM score of 0 to a ratio of 1:2 with a SHFM score of 4 (P trend <0.001).
The SHFM score provides information about the likely mode of death among ambulatory heart failure patients. Investigation is warranted to determine whether such information might predict responses to or cost-effectiveness of specific medications or devices in heart failure patients.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/CIRCULATIONAHA.106.687103</identifier><identifier>PMID: 17620506</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Aged ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood. Blood coagulation. Reticuloendothelial system ; Cardiology. Vascular system ; Cause of Death - trends ; Death, Sudden, Cardiac - epidemiology ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Female ; Heart Failure - mortality ; Humans ; Male ; Medical sciences ; Middle Aged ; Models, Cardiovascular ; Orthopedic surgery ; Pharmacology. Drug treatments ; Predictive Value of Tests ; Prospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Survival Rate - trends ; Washington - epidemiology</subject><ispartof>Circulation (New York, N.Y.), 2007-07, Vol.116 (4), p.392-398</ispartof><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c330t-498ddbd5f724362e32862b0ba35455910b38636cc5cad5625d57be0f29c2dd5a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18949397$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17620506$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MOZAFFARIAN, Dariush</creatorcontrib><creatorcontrib>ANKER, Stefan D</creatorcontrib><creatorcontrib>POOLE-WILSON, Philip A</creatorcontrib><creatorcontrib>LEVY, Wayne C</creatorcontrib><creatorcontrib>ANAND, Inder</creatorcontrib><creatorcontrib>LINKER, David T</creatorcontrib><creatorcontrib>SULLIVAN, Mark D</creatorcontrib><creatorcontrib>CLELAND, John G. F</creatorcontrib><creatorcontrib>CARSON, Peter E</creatorcontrib><creatorcontrib>MAGGIONI, Aldo P</creatorcontrib><creatorcontrib>MANN, Douglas L</creatorcontrib><creatorcontrib>PITT, Bertram</creatorcontrib><title>Prediction of mode of death in heart failure : The seattle heart failure model</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Prognosis and mode of death in heart failure patients are highly variable in that some patients die suddenly (often from ventricular arrhythmia) and others die of progressive failure of cardiac function (pump failure). Prediction of mode of death may facilitate decisions about specific medications or devices.
We used the Seattle Heart Failure Model (SHFM), a validated prediction model for total mortality in heart failure, to assess the mode of death in 10,538 ambulatory patients with New York Heart Association class II to IV heart failure and predominantly systolic dysfunction enrolled in 6 randomized trials or registries. During 16,735 person-years of follow-up, 2014 deaths occurred, which included 1014 sudden deaths and 684 pump-failure deaths. Compared with a SHFM score of 0, patients with a score of 1 had a 50% higher risk of sudden death, patients with a score of 2 had a nearly 3-fold higher risk, and patients with a score of 3 or 4 had a nearly 7-fold higher risk (P<0.001 for all comparisons; 1-year area under the receiver operating curve, 0.68). Stratification of risk of pump-failure death was even more pronounced, with a 4-fold higher risk with a score of 1, a 15-fold higher risk with a score of 2, a 38-fold higher risk with a score of 3, and an 88-fold higher risk with a score of 4 (P<0.001 for all comparisons; 1-year area under the receiver operating curve, 0.85). The proportion of deaths caused by sudden death versus pump-failure death decreased from a ratio of 7:1 with a SHFM score of 0 to a ratio of 1:2 with a SHFM score of 4 (P trend <0.001).
The SHFM score provides information about the likely mode of death among ambulatory heart failure patients. Investigation is warranted to determine whether such information might predict responses to or cost-effectiveness of specific medications or devices in heart failure patients.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Blood. Blood coagulation. Reticuloendothelial system</subject><subject>Cardiology. Vascular system</subject><subject>Cause of Death - trends</subject><subject>Death, Sudden, Cardiac - epidemiology</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Female</subject><subject>Heart Failure - mortality</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Models, Cardiovascular</subject><subject>Orthopedic surgery</subject><subject>Pharmacology. Drug treatments</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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F</creatorcontrib><creatorcontrib>CARSON, Peter E</creatorcontrib><creatorcontrib>MAGGIONI, Aldo P</creatorcontrib><creatorcontrib>MANN, Douglas L</creatorcontrib><creatorcontrib>PITT, Bertram</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MOZAFFARIAN, Dariush</au><au>ANKER, Stefan D</au><au>POOLE-WILSON, Philip A</au><au>LEVY, Wayne C</au><au>ANAND, Inder</au><au>LINKER, David T</au><au>SULLIVAN, Mark D</au><au>CLELAND, John G. F</au><au>CARSON, Peter E</au><au>MAGGIONI, Aldo P</au><au>MANN, Douglas L</au><au>PITT, Bertram</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prediction of mode of death in heart failure : The seattle heart failure model</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2007-07-24</date><risdate>2007</risdate><volume>116</volume><issue>4</issue><spage>392</spage><epage>398</epage><pages>392-398</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Prognosis and mode of death in heart failure patients are highly variable in that some patients die suddenly (often from ventricular arrhythmia) and others die of progressive failure of cardiac function (pump failure). Prediction of mode of death may facilitate decisions about specific medications or devices.
We used the Seattle Heart Failure Model (SHFM), a validated prediction model for total mortality in heart failure, to assess the mode of death in 10,538 ambulatory patients with New York Heart Association class II to IV heart failure and predominantly systolic dysfunction enrolled in 6 randomized trials or registries. During 16,735 person-years of follow-up, 2014 deaths occurred, which included 1014 sudden deaths and 684 pump-failure deaths. Compared with a SHFM score of 0, patients with a score of 1 had a 50% higher risk of sudden death, patients with a score of 2 had a nearly 3-fold higher risk, and patients with a score of 3 or 4 had a nearly 7-fold higher risk (P<0.001 for all comparisons; 1-year area under the receiver operating curve, 0.68). Stratification of risk of pump-failure death was even more pronounced, with a 4-fold higher risk with a score of 1, a 15-fold higher risk with a score of 2, a 38-fold higher risk with a score of 3, and an 88-fold higher risk with a score of 4 (P<0.001 for all comparisons; 1-year area under the receiver operating curve, 0.85). The proportion of deaths caused by sudden death versus pump-failure death decreased from a ratio of 7:1 with a SHFM score of 0 to a ratio of 1:2 with a SHFM score of 4 (P trend <0.001).
The SHFM score provides information about the likely mode of death among ambulatory heart failure patients. Investigation is warranted to determine whether such information might predict responses to or cost-effectiveness of specific medications or devices in heart failure patients.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>17620506</pmid><doi>10.1161/CIRCULATIONAHA.106.687103</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; American Heart Association Journals; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Aged Biological and medical sciences Blood and lymphatic vessels Blood. Blood coagulation. Reticuloendothelial system Cardiology. Vascular system Cause of Death - trends Death, Sudden, Cardiac - epidemiology Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Female Heart Failure - mortality Humans Male Medical sciences Middle Aged Models, Cardiovascular Orthopedic surgery Pharmacology. Drug treatments Predictive Value of Tests Prospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Survival Rate - trends Washington - epidemiology |
| title | Prediction of mode of death in heart failure : The seattle heart failure model |
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