Novel model aids prediction of survival in heart failure with reduced ejection fraction

For individuals with heart failure with reduced ejection fraction (HFrEF), a new model facilitates prediction of lifelong overall and heart failure hospitalization-free survival and treatment benefit, according to a study published online Sept. 10 in the European Journal of Heart Failure.

Pascal M. Burger, from the University Medical Centre Utrecht in the Netherlands, and colleagues developed and validated the LIFEtime-perspective for Heart Failure (LIFE-HF) model for predicting lifetime risk and treatment benefit in patients with HFrEF. The model was developed in 15,415 participants from the PARADIGM-HF and ATMOSPHERE trials. External validation was performed in 51,286 participants in the SwedeHF registry, ASIAN-HF registry, and DAPA-HF trial.

The researchers found adequate calibration of two- to 10-year risk, and the c-statistics were 0.65 to 0.74, respectively. The model was combined with hazard ratios from trials to allow estimation of an individual's (lifetime) risk and treatment benefit. Combined treatment with a mineralocorticoid receptor antagonist, sodium-glucose cotransporter 2 inhibitor, and angiotensin receptor-neprilysin inhibitor was estimated to afford a median of 2.5 and 3.7 additional years of overall and heart failure hospitalization-free survival, respectively, by applying the tool to the development cohort.

"The model could serve as a tool to improve the management of patients with HFrEF by facilitating personalized medicine and shared decision-making," the authors write.

Several authors disclosed ties to the pharmaceutical industry.