دورية
Abstract 12703: Transthyretin Amyloid Cardiomyopathy Among Patients Hospitalized for Heart Failure and Performance of an Adapted Wild-Type ATTR-CM Machine Learning Model: Findings From GWTG-HF
العنوان: | Abstract 12703: Transthyretin Amyloid Cardiomyopathy Among Patients Hospitalized for Heart Failure and Performance of an Adapted Wild-Type ATTR-CM Machine Learning Model: Findings From GWTG-HF |
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المؤلفون: | Peters, Anthony, Solomon, Nicole, Chiswell, Karen, Fonarow, Gregg C, Khouri, Michel G, Schepart, Alex, Baylor, Lori, Alvir, Jose, Bruno, Marianna, Huda, Ahsan, Allen, Larry A, Sharma, Kavita, Devore, Adam D, Greene, Stephen J |
المصدر: | Circulation (Ovid); November 2022, Vol. 146 Issue: Supplement 1 pA12703-A12703, 1p |
مستخلص: | Introduction:An 11-factor random forest model has been previously developed among ambulatory patients for identifying potential wild-type amyloidogenic TTR cardiomyopathy (wtATTR-CM), but model performance in a large sample of patients hospitalized for HF has not been evaluated.Methods:This study included Medicare beneficiaries hospitalized for HF in the Get With The Guidelines-HF® Registry from 2008-2019. Patients with and without a diagnosis of wtATTR-CM were compared. ICD9/10 codes were used as proxies to identify wtATTR-CM patients on inpatient/outpatient claims within ±6 months of hospitalization. Within a cohort matched 1:1 by age and sex, univariable logistic regression was used to evaluate relationships between each of the 11 factors of the established ATTR-CM model and wtATTR-CM. Discrimination and calibration of the 11-factor model was assessed.Results:Among 205,545 patients hospitalized for HF across 608 US hospitals, 627 patients (0.31%) had a diagnosis code for wtATTR-CM. wtATTR-CM patients were more likely to be male (69% vs 47%), Black race (23% vs 9%), and had lower systolic blood pressure (median 124 vs 139 mmHg). Univariable analysis within the 1:1 matched cohort of each of the 11-factors in the wtATTR-CM model found pericardial effusion, carpal tunnel syndrome, lumbar spinal stenosis, and elevated serum enzymes (e.g., troponin elevation) to be strongly associated with wtATTR-CM (Figure, Panel A). The 11-factor model showed modest discrimination with c-statistic of 0.65 (Figure, Panel B), with good calibration within the matched cohort (Figure, Panel C).Conclusions:Among patients hospitalized for HF in US practice, the number of wtATTR-CM as defined by diagnosis codes was low. Patients with a diagnosis of wtATTR-CM have a distinct clinical profile, and most factors within the prior 11-factor model were associated with greater odds of wtATTR-CM diagnosis. In this population, the wtATTR-CM model demonstrated modest discrimination. |
قاعدة البيانات: | Supplemental Index |
تدمد: | 00097322 15244539 |
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DOI: | 10.1161/circ.146.suppl_1.12703 |