Incorporation of natriuretic peptides with clinical risk scores to predict heart failure among individuals with dysglycaemia

Aims To evaluate the performance of the WATCH‐DM risk score, a clinical risk score for heart failure (HF), in patients with dysglycaemia and in combination with natriuretic peptides (NPs). Methods and results Adults with diabetes/pre‐diabetes free of HF at baseline from four cohort studies (ARIC, CH...

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Published in:European journal of heart failure 2022-01, Vol.24 (1), p.169-180
Main Authors: Segar, Matthew W., Khan, Muhammad Shahzeb, Patel, Kershaw V., Vaduganathan, Muthiah, Kannan, Vaishnavi, Willett, Duwayne, Peterson, Eric, Tang, W.H. Wilson, Butler, Javed, Everett, Brendan M., Fonarow, Gregg C., Wang, Thomas J., McGuire, Darren K., Pandey, Ambarish
Format: Article
Language:English
Subjects:
Adult
Biomarkers
Cohort Studies
Diabetes
Glucose Metabolism Disorders - epidemiology
Heart failure
Heart Failure - diagnosis
Heart Failure - epidemiology
Humans
Natriuretic Peptides
Pre‐diabetes
Risk Assessment - methods
Risk Factors
Risk prediction
Risk stratification
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Summary:Aims To evaluate the performance of the WATCH‐DM risk score, a clinical risk score for heart failure (HF), in patients with dysglycaemia and in combination with natriuretic peptides (NPs). Methods and results Adults with diabetes/pre‐diabetes free of HF at baseline from four cohort studies (ARIC, CHS, FHS, and MESA) were included. The machine learning‐ [WATCH‐DM(ml)] and integer‐based [WATCH‐DM(i)] scores were used to estimate the 5‐year risk of incident HF. Discrimination was assessed by Harrell's concordance index (C‐index) and calibration by the Greenwood–Nam–D'Agostino (GND) statistic. Improvement in model performance with the addition of NP levels was assessed by C‐index and continuous net reclassification improvement (NRI). Of the 8938 participants included, 3554 (39.8%) had diabetes and 432 (4.8%) developed HF within 5 years. The WATCH‐DM(ml) and WATCH‐DM(i) scores demonstrated high discrimination for predicting HF risk among individuals with dysglycaemia (C‐indices = 0.80 and 0.71, respectively), with no evidence of miscalibration (GND P ≥0.10). The C‐index of elevated NP levels alone for predicting incident HF among individuals with dysglycaemia was significantly higher among participants with low/intermediate (
ISSN:1388-9842
1879-0844
DOI:10.1002/ejhf.2375