Validation of the Get With The Guideline–Heart Failure risk score in Japanese patients and the potential improvement of its discrimination ability by the inclusion of B-type natriuretic peptide level

Shiraishi, Yasuyuki; Kohsaka, Shun; Abe, Takayuki; Mizuno, Atsushi; Goda, Ayumi; Izumi, Yuki; Yagawa, Mayuko; Akita, Keitaro; Sawano, Mitsuaki; Inohara, Taku; Takei, Makoto; Kohno, Takashi; Higuchi, Satoshi; Yamazoe, Masahiro; Mahara, Keitaro; Fukuda, Keiichi; Yoshikawa, Tsutomu

doi:10.1016/j.ahj.2015.10.008

Cited by 85 publications

(88 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Briefly, 100% of cases admitted at each participating institution that fulfilled inclusion criteria were registered. Inclusion and exclusion criteria of each registry has been described elsewhere9, 10, 11; all 3 registries did not include patients complicated with acute coronary syndrome. Data collection was patient based, but not event based, among all registries.…”

Section: Methodsmentioning

confidence: 99%

“…The WET‐HF (West Tokyo Heart Failure) registry is an ongoing, prospective, multicenter cohort registry designed to collect data on clinical backgrounds and outcomes of patients hospitalized for AHF 10. From January 2006, this registry was launched as a single‐center database of patients with AHF.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, we performed a risk‐score adjustment to evaluate changes in the in‐hospital mortality. Using the Get With The Guideline‐Heart Failure (GWTG‐HF) risk score, which has been validated in the Japanese AHF population,10 we calculated the predicted mortality rate of each patient. We then evaluated the ratio of the observed mean mortality rate against the predicted mean mortality rate for every year until 2015 using the Cochran–Armitage test.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

9‐Year Trend in the Management of Acute Heart Failure in Japan: A Report From the National Consortium of Acute Heart Failure Registries

Shiraishi

Kohsaka

Sato

et al. 2018

JAHA

Self Cite

168

111

View full text Add to dashboard Cite

BackgroundAcute heart failure (AHF) is a heterogeneous condition, and its characteristics and management patterns differ by region. Furthermore, limited evidence is available on AHF outside of Western countries. A project by the National Consortium of Acute Heart Failure Registries was designed to evaluate the trends over time in patient backgrounds, in‐hospital management patterns, and long‐term outcomes of patients with AHF over 9 years in Japan.Methods and ResultsBetween 2007 and 2015, registry data for patients with AHF were collected from 3 large‐scale quality AHF registries (ATTEND/WET‐HF/REALITY‐AHF). Predefined end points were trends over time in age, sex, and clinical outcomes, including short‐ and long‐term mortality and readmission for heart failure. The final data set consisted of 9075 patients with AHF. No significant differences in patient backgrounds and laboratory findings (eg, anemia or renal function) were observed, with the exception of patient age; mean age became substantially higher over 9 years (71.6–77.0 years; P for trend, <0.001). On the contrary, length of hospital stay became shorter (mean, 26–16 days). These changes were not associated with in‐hospital mortality (4.7–7.5%) or 30‐day heart failure readmission rate (4.8–5.4%), as well as 1‐year mortality and heart failure readmission rate (20.1–23.3% and 23.6–26.2%, respectively).ConclusionsLength of hospital stay in patients with AHF shortened over the 9‐year period despite the increasing age of the patients. However, short‐ and long‐term outcomes do not seem to be affected; continuous efforts to monitor clinical outcomes in patients with AHF are needed.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

9‐Year Trend in the Management of Acute Heart Failure in Japan: A Report From the National Consortium of Acute Heart Failure Registries

Shiraishi

Kohsaka

Sato

et al. 2018

JAHA

Self Cite

168

111

View full text Add to dashboard Cite

show abstract

“…The GWTG‐HF risk score was calculated using the 7 variables as previously reported 17, 18. A risk score was established using the following 7 predictor variables: age, systolic blood pressure, heart rate, blood urea nitrogen, sodium, chronic obstructive pulmonary disease, and race 17.…”

Section: Methodsmentioning

confidence: 99%

“…Multivariable logistic regression identified the following 7 predictors from the derivation samples; age, systolic blood pressure, blood urea nitrogen, heart rate, sodium, chronic obstructive pulmonary disease, and race 17. The GWTG‐HF score predicted the risk of in‐hospital mortality in patients with acute HF with preserved and reduced left ventricular ejection fraction (LVEF) 17, 18. However, the clinical impact of this GWTG‐HF risk score on prognosis in patients with chronic HF has not been evaluated.…”

Section: Introductionmentioning

confidence: 99%

Clinical Significance of Get With the Guidelines–Heart Failure Risk Score in Patients With Chronic Heart Failure After Hospitalization

Suzuki

Yoshihisa

Sato

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundThe Get With the Guidelines–Heart Failure (GWTG‐HF) risk score was developed using American Heart Association GWTG‐HF program data and predicts in‐hospital mortality in patients with acute heart failure (HF). We aimed to clarify the prognostic impacts of the GWTG‐HF risk score in patients with HF after discharge.Methods and ResultsWe examined the GWTG‐HF score in 1452 patients with HF, who were admitted to our hospital and discharged after treatment, by calculating 7 predetermined variables. We divided all subjects into 3 groups according to the GWTG‐HF risk score (low, moderate, and high score groups). The plasma B‐type natriuretic peptide level significantly increased with increasing GWTG‐HF risk score severity (median values of B‐type natriuretic peptide: 167.0 in low, 260.7 in moderate, and 418.2 pg/mL in high score groups). We followed up all subjects after discharge, and there were 347 (23.9%) all‐cause deaths and 407 (28.0%) cardiac events in follow‐up periods. A Kaplan‐Meier survival curve demonstrated that event rates of all‐cause death and cardiovascular events, including worsening HF and cardiac death, significantly increased with increasing GWTG‐HF risk score severity in all subjects, and also in 749 patients with HF with preserved ejection fraction (ejection fraction ≥50%) and 703 patients with HF with reduced ejection fraction (ejection fraction <50%) patients. The multivariable Cox proportional hazard regression analysis demonstrated that the GWTG‐HF risk score was one of the significant predictors of all‐cause mortality and cardiac events (all‐cause mortality: hazard ratio, 1.537, 95% confidence interval, 1.172–2.023; cardiac events: hazard ratio, 1.584, 95% confidence interval, 1.344–1.860, per 10‐point increase of GWTG‐HF score).ConclusionsThe GWTG‐HF risk score is a useful multivariable score model for several years after hospitalization in patients with HF in a Japanese population.

show abstract

Performance of the MAGGIC heart failure risk score and its modification with the addition of discharge natriuretic peptides

et al. 2018

Self Cite

View full text Add to dashboard Cite

AimsPredictive models for heart failure patients are widely used in the clinical practice to stratify patients' mortality and enable clinicians to tailor and intensify their approach. However, such models have not been validated internationally. In addition, biomarkers are now frequently measured to obtain prognostic information, and the implications of this practice are not known. In this study, we aimed to validate the model performance of the Meta‐analysis Global Group in Chronic Heart Failure (MAGGIC) score in a Japanese acute heart failure registry and further explore the incremental prognostic value of discharge B‐type natriuretic peptide (BNP) level.Methods and ResultsIn this study, we evaluated the registered data of 2215 consecutive acute HF patients (with 694 119 person‐years follow‐up) from a prospective multicentre registry (the West Tokyo Heart Failure) conducted in Japan from April 2006 to August 2016. The mean age was 73.0 ± 13.0, and 61.2% were male. The MAGGIC score demonstrated modest discrimination (c‐index = 0.71, 95% confidence interval 0.67–0.74) and good calibration (R 2 value = 0.97); there was constant overestimation for 1 year mortality. However, when the BNP level was added to the original MAGGIC variables, the model demonstrated good discrimination (c‐index = 0.74, 95% confidence interval 0.70–0.78) with adequate calibration (R 2 value = 0.91). The modified MAGGIC BNP score was externally validated in a separate Japanese registry (NaDEF) and demonstrated moderate discrimination (c‐index = 0.69, 95% confidence interval 0.65–0.73) and calibration (R 2 value = 0.85).ConclusionThe original MAGGIC score performed modestly in Japanese patients, but the addition of discharge BNP level enhanced model performance. The addition of objective biomarkers may result in effective modification of preexisting internationally recognized risk models and aid in multinational comparisons of heart failure patients' outcomes.

show abstract

Validation of the Get With The Guideline–Heart Failure risk score in Japanese patients and the potential improvement of its discrimination ability by the inclusion of B-type natriuretic peptide level

Cited by 85 publications

References 19 publications

9‐Year Trend in the Management of Acute Heart Failure in Japan: A Report From the National Consortium of Acute Heart Failure Registries

9‐Year Trend in the Management of Acute Heart Failure in Japan: A Report From the National Consortium of Acute Heart Failure Registries

Clinical Significance of Get With the Guidelines–Heart Failure Risk Score in Patients With Chronic Heart Failure After Hospitalization

Performance of the MAGGIC heart failure risk score and its modification with the addition of discharge natriuretic peptides

Contact Info

Product

Resources

About