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Clinical prediction of incident heart failure risk: a systematic review and meta-analysis


Yang, H and Negishi, K and Otahal, P and Marwick, TH, Clinical prediction of incident heart failure risk: a systematic review and meta-analysis, Open Heart, 2 Article e000222. ISSN 2053-3624 (2015) [Refereed Article]


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Licensed under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

DOI: doi:10.1136/openhrt-2014-000222


Background: Early treatment may alter progression to overt heart failure (HF) in asymptomatic individuals with stage B HF (SBHF). However, the identification of patients with SBHF is difficult. This systematic review sought to examine the strength of association of clinical factors with incident HF, with the intention of facilitating selection for HF screening.

Methods: Electronic databases were systematically searched for studies reporting risk factors for incident HF. Effect sizes, typically HRs, of each risk variable were extracted. Pooled crude and adjusted HRs with 95% CIs were computed for each risk variable using a random-effects model weighted by inverse variance.

Results: Twenty-seven clinical factors were identified to be associated with risk of incident HF in 15 observational studies in unselected community populations which followed 456 850 participants over 4–29 years. The strongest independent associations for incident HF were coronary artery disease (HRnbsp;= 2.94; 95% CI 1.36 to 6.33), diabetes mellitus (HR = 2.00; 95% CI 1.68 to 2.38), age (HR (per 10 years) = 1.80; 95% CI 1.13 to 2.87) followed by hypertension (HR = 1.61; 95% CI 1.33 to 1.96), smoking (HR = 1.60; 95% CI 1.45 to 1.77), male gender (HR = 1.52; 95% CI 1.24 to 1.87) and body mass index (HR (per 5 kg/m2) = 1.15; 95% CI 1.06 to 1.25). Atrial fibrillation (HR = 1.88; 95% CI 1.60 to 2.21), left ventricular hypertrophy (HR = 2.46; 95% CI 1.71 to 3.53) and valvular heart disease (HR = 1.74; 95% CI 1.07 to 2.84) were also strongly associated with incident HF but were not examined in sufficient papers to provide pooled hazard estimates.

Conclusions: Prediction of incident HF can be calculated from seven common clinical variables. The risk associated with these may guide strategies for the identification of high-risk people who may benefit from further evaluation and intervention.

Item Details

Item Type:Refereed Article
Keywords:heart failure
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Yang, H (Ms Hilda Yang)
UTAS Author:Negishi, K (Dr Kazuaki Negishi)
UTAS Author:Otahal, P (Mr Petr Otahal)
UTAS Author:Marwick, TH (Professor Tom Marwick)
ID Code:100026
Year Published:2015
Deposited By:Menzies Institute for Medical Research
Deposited On:2015-04-23
Last Modified:2016-02-18
Downloads:330 View Download Statistics

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