Author + information
- Received December 26, 2018
- Revision received February 18, 2019
- Accepted February 18, 2019
- Published online May 13, 2019.
- Sadiya S. Khan, MD, MSa,b,∗ (, )@HeartDocSadiya,
- Hongyan Ning, MD, MSb,
- Sanjiv J. Shah, MDa,
- Clyde W. Yancy, MD, SCMa,
- Mercedes Carnethon, PhDb,
- Jarett D. Berry, MDc,
- Robert J. Mentz, MDd,e,
- Emily O’Brien, PhDd,e,
- Adolfo Correa, MD, PhDf,
- Navin Suthahar, MD, MScg,
- Rudolf A. de Boer, MD, PhDg,
- John T. Wilkins, MD, MSa,b and
- Donald M. Lloyd-Jones, MD, ScMa,b
- aDivision of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- bDepartment of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- cDivision of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas
- dDuke Clinical Research Institute, Durham, North Carolina
- eDepartment of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
- fDepartment of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
- gUniversity Medical Centre Groningen, University of Groningen, Department of Cardiology, Groningen, the Netherlands
- ↵∗Address for correspondence:
Dr. Sadiya S. Khan, Division of Cardiology, Department of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lake Shore Drive, 14-002, Chicago, Illinois 60611.
Background Primary prevention strategies to mitigate the burden of heart failure (HF) are urgently needed. However, no validated risk prediction tools are currently in use.
Objectives This study sought to derive 10-year risk equations of developing incident HF.
Methods Race- and sex-specific 10-year risk equations for HF were derived and validated from individual-level data from 7 community-based cohorts with at least 12 years of follow-up. Participants who were recruited between 1985 and 2000, between 30 to 79 years, and were free of cardiovascular disease at baseline were included to create a pooled cohort (PC) and were randomly split for derivation and internal validation. Model performance was also assessed in 2 additional cohorts.
Results In the derivation sample of the PC (n = 11,771), 58% were women, 22% were black with a mean age of 52 ± 12 years, and HF occurred in 1,339 participants. Predictors of HF included in the race–sex-specific models were age, blood pressure (treated or untreated), fasting glucose (treated or untreated), body mass index, cholesterol, smoking status, and QRS duration. The PC equations to Prevent HF model had good discrimination and strong calibration in internal and external validation cohorts. A web-based tool was developed to facilitate clinical application of this tool.
Conclusions The authors present a contemporary analysis from 33,010 men and women demonstrating the utility of the sex- and race-specific 10-year PC equations to Prevent HF risk score, which integrates clinical parameters readily available in primary care settings. This tool can be useful in risk-based decision making to determine who may merit intensive screening and/or targeted prevention strategies.
This research was supported, in part, by the National Institutes of Health's (NIH’s) National Center for Advancing Translational Sciences, grant number KL2TR001424. Supported by grants from the NIH/National Heart, Lung, and Blood Institute (NHLBI) to Dr. Lloyd-Jones (R21 HL085375) and the Netherlands Heart Foundation (CVON DOSIS, grant 2014-40 and CVON RED-CVD, grant 2017-11 to Dr. de Boer and CVON SHE-PREDICTS-HF grant 2017-21 to Drs. de Boer and Suthahar). The Jackson Heart Study is supported and conducted in collaboration with Jackson State University (HHSN268201800013I), Tougaloo College (HHSN268201800014I), the Mississippi State Department of Health (HHSN268201800015I/HHSN26800001), and the University of Mississippi Medical Center (HHSN268201800010I, HHSN268201800011I and HHSN268201800012I) contracts from the NHLBI and the National Institute for Minority Health and Health Disparities (NIMHD). The views expressed in this paper are those of the authors and do not necessarily represent the views of the NHLBI, the NIH, or the U.S. Department of Health and Human Services. The University Medical Centre Groningen, which employs Drs. De Boer and Suthahar; and has received research grants and/or fees from AstraZeneca, Abbott, Bristol-Myers Squibb, Novartis, Roche, Trevena, and Thermo Fisher. Dr. Shah has received research funding from Actelion, AstraZeneca, Corvia, and Novartis; and has received consulting fees from Actelion, AstraZeneca, Amgen, Bayer, Boehringer Ingelheim, Cardiora, Eisai, Ironwood, Merck, Novartis, Sanofi, Tenax, and United Therapeutics. Dr. Berry has been a consultant for AstraZeneca. Dr. Mentz has received research support from the National Institutes of Health (U01HL125511-01A1, U10HL110312 and R01AG045551-01A1), Akros, Amgen, AstraZeneca, Bayer, GlaxoSmithKline, Gilead, InnoLife, Luitpold/American Regent, Medtronic, Merck, and Novartis; has received honoraria from Abbott, Amgen, AstraZeneca, Bayer, Boston Scientific, Janssen, Luitpold Pharmaceuticals, Medtronic, Merck, and Novartis; and has served on an advisory board for Amgen, AstraZeneca, Merck, Novartis and Boehringer Ingelheim. Dr. Wilkins has been a consultant for NGM Biopharmaceuticals. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received December 26, 2018.
- Revision received February 18, 2019.
- Accepted February 18, 2019.
- 2019 American College of Cardiology Foundation
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