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Dynamic changes in cardiovascular and systemic variables prior to sudden cardiac death in heart failure with reduced ejection fraction: A PARADIGM‐HF analysis

European Journal of Heart Failure Feb 13, 2021

Rohde LE, Vaduganathan M, Claggett BL, et al. - Given that data at only a single time‐point is typically included in the prognostic models of sudden cardiac death (SCD), therefore, researchers sought to determine independent predictors of SCD addressing the effect of combining time‐varying covariates to improve prediction evaluation. A total of 8,399 patients enrolled in the PARADIGM‐HF trial were examined. The independent contribution of 7 time‐updated variables to the risk of SCD was evident in multivariable models adjusted for baseline covariates. In classification and regression tree analysis, improved risk stratification was afforded by baseline variables (implantable cardioverter defibrillator use and N‐terminal prohormone of B‐type natriuretic peptide levels) as well as time‐updated covariates (NYHA class, total bilirubin, and total cholesterol). Overall, experts concluded that distinct alterations in multiple cardiac‐specific and systemic variables, beyond single time‐point assessments, not only led to improved SCD risk prediction but also assisted in discriminating mode of death in chronic HF.

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