A novel risk model to predict first-ever ischemic stroke in heart failure with reduced ejection fraction

Zhou, Xiaodong; Yu, Lingfang; Hu, Wenlong; Shi, Ruiyu; Ji, Yinan; Zhou, Changzuan; Xue, Chenglong; Yu, Guojia; Huang, Weijian; Shan, Peiren

doi:10.18632/aging.202458

Cited by 3 publications

(5 citation statements)

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“…Third, adequately affirming the role of cardio-functional factors and thrombotic markers may be critical to the accurate prediction of thrombotic events with our model. As in many other studies, DD and LVEF were important indicators of VT in patients with DCM [ 22 , 27 ].…”

Section: Discussionsupporting

confidence: 67%

“…To date, several serological markers have been implicated in the occurrence and development of VT. Ample evidence confirms that DD is not only good at in predicting left atrial thrombus in patients with atrial fibrillation, but is also more sensitive and accurate in predicting intraventricular thrombus in patients with heart failure [ 19 – 22 ]. In our study, DD levels were significantly elevated in DCM patients with VT and confirmed that DD may be a most important independent biomarker for predicting VT. Other studies showed that patients with high UA levels were often at high risk for venous thromboembolism, systemic disease embolism and left atrial thrombosis [ 23 – 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, deterioration of cardiac function was also a significant cause of VT [ 22 ]. Traditionally, cardiac function was assessed primarily by LVEF and NYHA, while the NT-proBNP was widely used to assess ventricular function as a major marker of ventricular function.…”

Section: Discussionmentioning

confidence: 99%

“…However, these scores were not satisfactory in predicting thrombosis in patients with heart failure. Zhou et al [ 22 ] showed that CHADS2 score and CHA2DS2-VASc score performed not well with small AUC of 0.52 and 0.55 for predicting stroke in patients with heart failure. Some other literatures reported that CHA2DS2-VASc or ATRIA scores had underestimated stroke risk of heart failure patients [ 22 , 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…Zhou et al [ 22 ] showed that CHADS2 score and CHA2DS2-VASc score performed not well with small AUC of 0.52 and 0.55 for predicting stroke in patients with heart failure. Some other literatures reported that CHA2DS2-VASc or ATRIA scores had underestimated stroke risk of heart failure patients [ 22 , 30 , 31 ]. Concordant with these reports, in our study, CHADS2, CHA2DS2-VASc and ATRIA had lower AUC (0.53, 0.50, 0.56), and significantly underestimated the thrombotic risk in DCM patients, as shown in Fig.…”

Section: Discussionmentioning

confidence: 99%

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A nomogram to predict ventricular thrombus in dilated cardiomyopathy patients

Adi

et al. 2023

J Thromb Thrombolysis

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Background: VT (Ventricular Thrombus) is a serious complication of dilated cardiomyopathy (DCM). Our goal is to develop a nomogram for personalized prediction of incident VT in DCM patients. Methods: 1267 patients (52.87 ± 11.75 years old, 73.8% male) were analyzed retrospectively from January 01, 2015, to December 31, 2020. A nomogram model for VT risk assessment was established using minimum absolute contraction and selection operator (LASSO) and multivariate logistic regression analysis, and its effectiveness was validated by internal guidance. The model was evaluated by the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA). We compared the performance in predicting VT between nomogram and CHA2DS2, CHA2DS2- VASc or ATRIA by AUC, akaike information criterion (AIC), bayesian information criterion (BIC), net reclassification index (NRI), and integrated discrimination index (IDI). Results: 89 patients (7.02%) experienced VT. Multivariate logistic regression analysis revealed that age, left ventricular ejection fraction (LVEF), uric acid (UA), N-terminal precursor B-type diuretic peptide (NT-proBNP), and D-dimer (DD) were important independent predictors of VT. The nomogram model correctly separates patients with and without VT, with an optimistic C score of 0.92 (95%CI: 0.90–0.94) and good calibration (Hosmer-Lemeshow χ2 = 11.51, P = 0.12). Our model showed improved prediction of VT compared to CHA2DS2, CHA2DS2-VASc or ATRIA (all P < 0.05). Conclusions: The novel nomogram demonstrated better than presenting scores and showed an improvement in predicting VT in DCM patients.

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Section: Discussionsupporting

confidence: 67%