Clinical Electrophysiology -> SCA Risk Assessment: -> Clinical Risk Assessment Techniques D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-212 - Application Of The Seattle Proportional Risk Model To Predict Sudden Cardiac Death In Heart Failure With Preserved Ejection Fraction (ID 1237)

Abstract

Background: Although sudden cardiac death (SCD) is a common mode of death in heart failure with preserved ejection fraction (HFpEF), the proportion of SCD to other deaths is lower than it is for patients with reduced EF. Seattle Proportional Risk Model (SPRM) was designed to identify heart failure subgroups with a higher proportion of SCD.
Objective: To assess the performance of SPRM in HFpEF
Methods: We validated SPRM among 3425 patients with HFpEF enrolled in the TOPCAT trial. An independent endpoints committee adjudicated SCD.
Results: Mean age (SD) of the 3425 patients was 68.6 (9.6) and 48.5% were male. Over a mean 3.4 (1.6) years of follow-up, 128 (3.7%) patients had SCD and 397 (11.6%) died of other causes. SCD constituted 24% of deaths in the whole cohort, 35% of deaths in patients with EF < 50%, and 22% of deaths in those with EF ≥ 50% (Table). SPRM categorized the cohort into 5 quintiles according to proportional risk of SCD. Whereas SCD constituted 12.5% of deaths in SPRM quintile 1, this proportion increased to 33.8% in SPRM quintile 5. A one point increase in SPRM score was associated with 3 times higher odds of SCD vs non-SCD (95% confidence interval 1.97 to 4.64; p < 0.001) in the whole cohort, 2.9 times higher risk in those with EF < 50%, and 2.8 times higher risk in those with EF > 50% (Table). SPRM had a c-index of 0.66 in discriminating SCD from non-SCD deaths.
Conclusion: SPRM identifies a subset of HFpEF patients with a higher proportion of SCD.
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