Abstract 11145: Traditional and Novel Risk Factors Can Estimate Five Year Risk of Developing Heart Failure: Results From the Multi-ethnic Study of Atherosclerosis
Introduction: Heart failure (HF) is a leading cause of mortality especially in elderly. Early detection of at risk individuals is important for preventive strategies. Prior risk scores are derived from populations with specific risk factors and did not include ethnic diversity. The purpose of this study was to develop a risk model using traditional and novel risk factors from a community dwelling multi ethnic population without clinical cardiovascular disease at baseline.
Methods: The Multi Ethnic Study of Atherosclerosis (MESA) study is a multicenter observational cohort study following 6814 subjects (mean age 62±10 years; 47% men; 38% White, 28% Black, 22% Hispanic & 12% Chinese). Left ventricle (LV) mass was measured with MRI and indexed to body surface area. Mean follow up time was 7 years. Cox proportional hazards models and regression coefficients were used to determine independent risk factors and generate 5 year risk score for HF (n=176). Interactions with age, sex and ethnicity were tested after correction for multiple hypotheses. Bootstrapping with bias correction was used for internal validation.
Results: Independent predictors for HF (hazard ratio, p value) were age (1.30 per 10 years,<0.001), male gender (2.27,<0.01), current smoking(1.97,<0.001), BMI (1.35 per 5kg/m2,<0.01), systolic BP (1.10 per 10mm Hg,<0.001), heart rate (1.30 per 10 bpm,<0.05), diabetes (2.27,<0.001), log of NTproBNP (2.48 per unit increment,<0.001) and LV mass index (1.20 per 10g/m2,<0.01). C statistic for the model with NTproBNP was 0.87. Heart rate was a stronger predictor of HF in women (p=0.004); LV mass index was more strongly associated with HF risk in Whites (p=0.002). NTproBNP improved net reclassification index (0.15, p=0.02). A point system defined low, medium and high risk study subjects.
Conclusion: HF risk can be predicted using traditional risk factors, heart rate, LV mass and NTproBNP in an adult multi ethnic population.
- © 2012 by American Heart Association, Inc.