Development of a novel heart failure risk tool: the barcelona bio-heart failure risk calculator (BCN bio-HF calculator).

<h4>Background</h4>A combination of clinical and routine laboratory data with biomarkers reflecting different pathophysiological pathways may help to refine risk stratification in heart failure (HF). A novel calculator (BCN Bio-HF calculator) incorporating N-terminal pro B-type natriuret...

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Autores principales:	Josep Lupón, Marta de Antonio, Joan Vila, Judith Peñafiel, Amparo Galán, Elisabet Zamora, Agustín Urrutia, Antoni Bayes-Genis
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/344d0afbc1ac4055961157215ff7fc75
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spelling	oai:doaj.org-article:344d0afbc1ac4055961157215ff7fc752021-11-18T08:37:40ZDevelopment of a novel heart failure risk tool: the barcelona bio-heart failure risk calculator (BCN bio-HF calculator).1932-620310.1371/journal.pone.0085466https://doaj.org/article/344d0afbc1ac4055961157215ff7fc752014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24454874/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>A combination of clinical and routine laboratory data with biomarkers reflecting different pathophysiological pathways may help to refine risk stratification in heart failure (HF). A novel calculator (BCN Bio-HF calculator) incorporating N-terminal pro B-type natriuretic peptide (NT-proBNP, a marker of myocardial stretch), high-sensitivity cardiac troponin T (hs-cTnT, a marker of myocyte injury), and high-sensitivity soluble ST2 (ST2), (reflective of myocardial fibrosis and remodeling) was developed.<h4>Methods</h4>Model performance was evaluated using discrimination, calibration, and reclassification tools for 1-, 2-, and 3-year mortality. Ten-fold cross-validation with 1000 bootstrapping was used.<h4>Results</h4>The BCN Bio-HF calculator was derived from 864 consecutive outpatients (72% men) with mean age 68.2 ± 12 years (73%/27% New York Heart Association (NYHA) class I-II/III-IV, LVEF 36%, ischemic etiology 52.2%) and followed for a median of 3.4 years (305 deaths). After an initial evaluation of 23 variables, eight independent models were developed. The variables included in these models were age, sex, NYHA functional class, left ventricular ejection fraction, serum sodium, estimated glomerular filtration rate, hemoglobin, loop diuretic dose, β-blocker, Angiotensin converting enzyme inhibitor/Angiotensin-2 receptor blocker and statin treatments, and hs-cTnT, ST2, and NT-proBNP levels. The calculator may run with the availability of none, one, two, or the three biomarkers. The calculated risk of death was significantly changed by additive biomarker data. The average C-statistic in cross-validation analysis was 0.79.<h4>Conclusions</h4>A new HF risk-calculator that incorporates available biomarkers reflecting different pathophysiological pathways better allowed individual prediction of death at 1, 2, and 3 years.Josep LupónJosep LupónMarta de AntonioJoan VilaJudith PeñafielAmparo GalánElisabet ZamoraAgustín UrrutiaAntoni Bayes-GenisPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 1, p e85466 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Josep Lupón Josep Lupón Marta de Antonio Joan Vila Judith Peñafiel Amparo Galán Elisabet Zamora Agustín Urrutia Antoni Bayes-Genis Development of a novel heart failure risk tool: the barcelona bio-heart failure risk calculator (BCN bio-HF calculator).
description	<h4>Background</h4>A combination of clinical and routine laboratory data with biomarkers reflecting different pathophysiological pathways may help to refine risk stratification in heart failure (HF). A novel calculator (BCN Bio-HF calculator) incorporating N-terminal pro B-type natriuretic peptide (NT-proBNP, a marker of myocardial stretch), high-sensitivity cardiac troponin T (hs-cTnT, a marker of myocyte injury), and high-sensitivity soluble ST2 (ST2), (reflective of myocardial fibrosis and remodeling) was developed.<h4>Methods</h4>Model performance was evaluated using discrimination, calibration, and reclassification tools for 1-, 2-, and 3-year mortality. Ten-fold cross-validation with 1000 bootstrapping was used.<h4>Results</h4>The BCN Bio-HF calculator was derived from 864 consecutive outpatients (72% men) with mean age 68.2 ± 12 years (73%/27% New York Heart Association (NYHA) class I-II/III-IV, LVEF 36%, ischemic etiology 52.2%) and followed for a median of 3.4 years (305 deaths). After an initial evaluation of 23 variables, eight independent models were developed. The variables included in these models were age, sex, NYHA functional class, left ventricular ejection fraction, serum sodium, estimated glomerular filtration rate, hemoglobin, loop diuretic dose, β-blocker, Angiotensin converting enzyme inhibitor/Angiotensin-2 receptor blocker and statin treatments, and hs-cTnT, ST2, and NT-proBNP levels. The calculator may run with the availability of none, one, two, or the three biomarkers. The calculated risk of death was significantly changed by additive biomarker data. The average C-statistic in cross-validation analysis was 0.79.<h4>Conclusions</h4>A new HF risk-calculator that incorporates available biomarkers reflecting different pathophysiological pathways better allowed individual prediction of death at 1, 2, and 3 years.
format	article
author	Josep Lupón Josep Lupón Marta de Antonio Joan Vila Judith Peñafiel Amparo Galán Elisabet Zamora Agustín Urrutia Antoni Bayes-Genis
author_facet	Josep Lupón Josep Lupón Marta de Antonio Joan Vila Judith Peñafiel Amparo Galán Elisabet Zamora Agustín Urrutia Antoni Bayes-Genis
author_sort	Josep Lupón
title	Development of a novel heart failure risk tool: the barcelona bio-heart failure risk calculator (BCN bio-HF calculator).
title_short	Development of a novel heart failure risk tool: the barcelona bio-heart failure risk calculator (BCN bio-HF calculator).
title_full	Development of a novel heart failure risk tool: the barcelona bio-heart failure risk calculator (BCN bio-HF calculator).
title_fullStr	Development of a novel heart failure risk tool: the barcelona bio-heart failure risk calculator (BCN bio-HF calculator).
title_full_unstemmed	Development of a novel heart failure risk tool: the barcelona bio-heart failure risk calculator (BCN bio-HF calculator).
title_sort	development of a novel heart failure risk tool: the barcelona bio-heart failure risk calculator (bcn bio-hf calculator).
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/344d0afbc1ac4055961157215ff7fc75
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Development of a novel heart failure risk tool: the barcelona bio-heart failure risk calculator (BCN bio-HF calculator).

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