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Prediction of incident heart failure in established atherosclerotic cardiovascular disease: the SMART2-HF model.

• アブストラクト	BACKGROUND AND AIMS: Patients with established atherosclerotic cardiovascular disease (ASCVD) are at high risk of developing heart failure (HF). However, incident HF is not part of the risk assessment of current guideline-recommended models. The aim of this study was to develop and externally validate the SMART2-HF model for prediction of incident HF in patients with ASCVD. METHODS: SMART2-HF was developed in 7698 individuals with established ASCVD (coronary, cerebrovascular, or peripheral artery disease, or abdominal aortic aneurysm) but without prior HF from the UCC-SMART cohort. Cox proportional hazards models including sex-predictor interactions and with age as the time scale were derived to estimate the 10-year and lifetime risk of incident HF (hospitalization for HF or HF-related death), accounting for competing non-HF mortality. Predictors, limited to routinely available clinical characteristics, were aligned with the SMART2 risk model for recurrent cardiovascular risk in the same population. External validation was performed in 240 741 patients with ASCVD from six data sources: the Clinical Practice Research Datalink, the HUNT3 study, the SWEDEHEART Registry, the ASCVD-Particles cohort, the Estonian Biobank and the international REACH Registry. RESULTS: During a median follow-up of 11.2 years (interquartile range 6.1-16.4 years), 1031 incident HF events (13%) occurred in the UCC-SMART cohort. In the external validation data sources, a total of 24 885 incident HF events (10%) occurred. The pooled C-statistic was 0.696 (95% confidence interval 0.674-0.717), with consistent performance in subgroups by sex and type of ASCVD. Predicted risks matched observed incidence in external validation. CONCLUSIONS: The SMART2-HF model enables the prediction of incident HF in patients with ASCVD. Aligned with the guideline-recommended SMART2 model for recurrent cardiovascular risk, SMART2-HF can be used as a complementary tool in this population.
  ジャーナル名	European heart journal
  Pubmed追加日	2026/3/11
  投稿者	Reitsma, Tessa H; Lim, Carl-Emil; Gynnild, Mari N; Kaptoge, Stephen; Loo, Laura; Holtrop, Joris; Kuzma, Lukasz; Pennells, Lisa; Conrad, Nathalie; Ueda, Peter; Jernberg, Tomas; Kurasz, Anna; Keene, Spencer J; Chilala, Chimweta; Deo, Salil V; Tillmann, Taavi; Khunti, Kamlesh; Piepoli, Massimo; Rossello, Xavier; Savarese, Gianluigi; Dalen, Havard; Steg, Ph Gabriel; Wood, Angela M; Lees, Jennifer S; Kavousi, Maryam; McEvoy, John William; de Boer, Rudolf A; Andersson, Charlotte; Bhatt, Deepak L; Visseren, Frank L J; Dorresteijn, Jannick A N; Koudstaal, Stefan; Di Angelantonio, Emanuele; Hageman, Steven H J
  組織名	Department of Vascular Medicine and Endocrinology, University Medical Centre;Utrecht, Utrecht, The Netherlands.;Karolinska Institutet, Clinical Epidemiology Division, Department of Medicine,;Stockholm, Sweden.;Clinic of Cardiology, St. Olav University Hospital, Trondheim, Norway.;Department of Circulation and Medical Imaging, Faculty of Medicine and Health;Science, NTNU - Norwegian University of Science and Technology, Trondheim,;Norway.;K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine,;University of Oslo, Norway.;British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public;Health and Primary Care, University of Cambridge, Papworth Road, Cambridge;Biomedical Campus, Cambridge, UK.;Victor Phillip Dahdaleh Heart and Lung Research Institute, University of;Cambridge, Cambridge UK.;Institute of Family Medicine and Public Health, University of Tartu, Tartu,;Estonia.;Medical University of Bialystok, Department of Invasive Cardiology, Bialystok,;Poland.;National Medical Institute of the Ministry of Interior, Department of Cardiac;Surgery and Transplantology, Warsaw, Poland.;Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool,;UK.;British Heart Foundation Centre of Research Excellence, University of Cambridge,;Cambridge, UK.;Nuffield Department of Women's and Reproductive Health, University of Oxford, UK.;Department of Cardiovascular Sciences, Leuven, Belgium.;Department of Clinical Sciences, Cardiology, Karolinska Institutet Danderyd;Hospital, Stockholm, Sweden.;Surgical Services, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.;Case School of Medicine, Case Western Reserve University School of Medicine,;Cleveland, OH, USA.;School of Health and Wellbeing, University of Glasgow, United Kingdom.;Diabetes Research Centre, Leicester General Hospital, University of Leicester,;Leicester, UK.;Department of Biomedical Science for Health, University of Milan, Italy.;Clinical University Cardiology, IRCCS Policlinico San Donato, Milan, Italy.;Hospital Universitario Son Espases, Health Research Institute of the Balearic;Islands, Universitat Illes Balears, Palma de Mallorca, Spain.;Department of Clinical Science and Education, Sodersjukhuset; Karolinska;Institute, Stockholm, Sweden.;Levanger Hospital, Nord-Trondelag Hospital Trust, Levanger, Norway.;Universite Paris-Cite, FACT, French Alliance for Cardiovascular Trials, AP-HP;;Hopital Bichat; and INSERM U-1148, France.;National Institute for Health and Care Research Blood and Transplant Research;Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK.;Health Data Research UK Cambridge, Wellcome Genome Campus and University of;Cambridge, Cambridge, UK.;British Heart Foundation Data Science Centre, Health Data Research UK, London,;School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK.;Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam,;Rotterdam, The Netherlands.;University of Galway School of Medicine and National Institute for Prevention and;Cardiovascular Health, Galway, Ireland.;Cardiovascular Institute, Erasmus MC, Department of Cardiology, Thorax Center,;Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte,;Herlev, Denmark.;Center for Advanced Heart Disease, Brigham and Women's Hospital and Harvard;Medical School, Boston, MA, USA.;Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New;York, NY, USA.;Health Data Science Research Centre, Human Technopole, Milan, Italy.
  Pubmed リンク	https://www.ncbi.nlm.nih.gov/pubmed/41810961/

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