Uijl, A;
Lund, LH;
Vaartjes, I;
Brugts, JJ;
Linssen, GC;
Asselbergs, FW;
Hoes, AW;
... Savarese, G; + view all
(2020)
A registry‐based algorithm to predict ejection fraction in patients with heart failure.
ESC Heart Failure
10.1002/ehf2.12779.
(In press).
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Abstract
Aims: Left ventricular ejection fraction (EF) is required to categorize heart failure (HF) [i.e. HF with preserved (HFpEF), mid‐range (HFmrEF), and reduced (HFrEF) EF] but is often not captured in population‐based cohorts or non‐HF registries. The aim was to create an algorithm that identifies EF subphenotypes for research purposes. / Methods and results: We included 42 061 HF patients from the Swedish Heart Failure Registry. As primary analysis, we performed two logistic regression models including 22 variables to predict (i) EF≥ vs. <50% and (ii) EF≥ vs. <40%. In the secondary analysis, we performed a multivariable multinomial analysis with 22 variables to create a model for all three separate EF subphenotypes: HFrEF vs. HFmrEF vs. HFpEF. The models were validated in the database from the CHECK‐HF study, a cross‐sectional survey of 10 627 patients from the Netherlands. The C‐statistic (discrimination) was 0.78 [95% confidence interval (CI) 0.77–0.78] for EF ≥50% and 0.76 (95% CI 0.75–0.76) for EF ≥40%. Similar results were achieved for HFrEF and HFpEF in the multinomial model, but the C‐statistic for HFmrEF was lower: 0.63 (95% CI 0.63–0.64). The external validation showed similar discriminative ability to the development cohort. / Conclusions: Routine clinical characteristics could potentially be used to identify different EF subphenotypes in databases where EF is not readily available. Accuracy was good for the prediction of HFpEF and HFrEF but lower for HFmrEF. The proposed algorithm enables more effective research on HF in the big data setting.
| Type: | Article |
|---|---|
| Title: | A registry‐based algorithm to predict ejection fraction in patients with heart failure |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/ehf2.12779 |
| Publisher version: | https://doi.org/10.1002/ehf2.12779 |
| Language: | English |
| Additional information: | Copyright © 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
| Keywords: | Electronic health records, Heart failure, Ejection fraction, Prediction, HFrEF, HFmrEF, HFpEF |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10105396 |
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