(based on Kannel, D'Agostino, Silbershatz, Belanger, Wilson, Levy. 'Profile for Estimating Risk of Heart Failure' - Arch Intern. Med. 1999)
Outcome
Congestive Heart Failure
Duration of follow-up
Maximum of 38 years, 4-year risk prediction (pooled logistic regression)
Population of interest
Individuals 45 to 94 years old with coronary disease, hypertension or valvular disease
Predictors
- Age
- Left Ventricular Hypertrophy
- Heart rate
- Systolic Blood Pressure
- Coronary Heart Disease
- Valve Disease
- Diabetes
- BMI
- Vital Capacity (some models)
- Cardiomegaly (some models)
Probability of Congestive Heart Failure Within 4 Years for
Men Aged 45 to 94 Years
With Coronary Disease, Hypertension, or Valvular Disease*
Model including vital capacity and chest x-ray results
| Points |
|
0 |
1 |
2 |
3 |
4 |
| Age,y |
45-49 |
50-54 |
55-59 |
60-64 |
65-69 |
| Forced vital capacity, cL |
≥425 |
375-424 |
325-374 |
275-324 |
200-274 |
| Systolic blood pressure, mm Hg |
<120 |
120-139 |
140-169 |
170-189 |
190-219 |
| Heart rate, bpm |
<55 |
55-64 |
65-79 |
80-89 |
90-99 |
| LVH on ECG |
No |
|
|
|
|
| Coronary heart disease |
No |
|
|
|
|
| Valve disease |
No |
|
|
|
|
| Diabetes |
No |
Yes |
|
|
|
| Cardiomegaly |
No |
|
|
|
|
| Points |
|
5 |
6 |
7 |
8 |
9 |
| Age,y |
70-74 |
75-79 |
80-89 |
90-94 |
|
| Forced vital capacity, cL |
150-199 |
≤149 |
|
|
|
| Systolic blood pressure, mm Hg |
>219 |
|
|
|
|
| Heart rate, bpm |
>99 |
|
|
|
|
| LVH on ECG |
Yes |
|
|
|
|
| Coronary heart disease |
|
|
|
|
Yes |
| Valve disease |
Yes |
|
|
|
|
| Diabetes |
|
|
|
|
|
| Cardiomegaly |
Yes |
|
|
|
|
| Points |
4-Year Probability, % |
Points |
4-Year Probability, % |
| 5 |
1 |
26 |
18 |
| 10 |
1 |
27 |
21 |
| 12 |
2 |
28 |
24 |
| 14 |
3 |
29 |
27 |
| 16 |
4 |
30 |
31 |
| 18 |
5 |
31 |
34 |
| 20 |
7 |
33 |
38 |
| 22 |
10 |
33 |
42 |
| 24 |
14 |
34 |
47 |
| 25 |
16 |
35 |
51 |
*LVH indicates left ventricular hypertrophy; ECG, electrocardiogram.
Probability of Congestive Heart Failure Within 4 Years for
Men Aged 45 to 94 Years
With Coronary Disease, Hypertension, or Valvular Disease*
Model without vital capacity and chest x-ray results
| Points |
|
0 |
1 |
2 |
3 |
4 |
| Age, y |
45-49 |
50-54 |
55-59 |
60-64 |
65-69 |
| Systolic blood pressure, mm Hg |
<120 |
120-139 |
140-169 |
170-189 |
190-219 |
| Heart rate, bpm |
<55 |
55-64 |
65-79 |
80-89 |
90-104 |
| LVH on ECG |
No |
|
|
|
Yes |
| Coronary heart disease |
No |
|
|
|
|
| Valve disease |
No |
|
|
|
|
| Diabetes |
No |
Yes |
|
|
|
| Points |
|
5 |
6 |
7 |
8 |
9 |
| Age, y |
70-74 |
75-79 |
80-84 |
85-89 |
90-94 |
| Systolic blood pressure, mm Hg |
>219 |
|
|
|
|
| Heart rate, bpm |
>104 |
|
|
|
|
| LVH on ECG |
|
|
|
|
|
| Coronary heart disease |
|
|
|
Yes |
|
| Valve disease |
Yes |
|
|
|
|
| Diabetes |
|
|
|
|
|
| Points |
4-Year Probability, % |
Points |
4-Year Probability, % |
| 5 |
1 |
24 |
30 |
| 10 |
3 |
25 |
34 |
| 12 |
3 |
26 |
39 |
| 14 |
5 |
27 |
44 |
| 16 |
8 |
28 |
49 |
| 18 |
11 |
29 |
54 |
| 20 |
16 |
30 |
59 |
| 22 |
22 |
|
|
*LVH indicates left ventricular hypertrophy; ECG, electrocardiogram.
Probability of Congestive Heart Failure Within 4 Years for
Women Aged 45 to 94 Years
With Coronary Disease, Hypertension, or Valvular Disease*
Model including vital capacity and chest x-ray results
| Points |
|
0 |
1 |
2 |
3 |
4 |
| Age, y |
45-49 |
50-59 |
60-69 |
70-79 |
80-89 |
| Forced vital capacity, cL |
>299 |
250-299 |
200-249 |
150-199 |
<150 |
| Systolic blood pressure, mmHg |
<130 |
130-189 |
>189 |
|
|
| Heart rate, bpm |
<55 |
55-79 |
80-99 |
>99 |
|
| LVH on ECG |
No |
|
|
|
|
| Coronary Heart Disease |
No |
|
|
|
|
| Cardiomegaly |
No |
|
Yes |
|
|
| Valve Disease |
No |
|
|
|
|
| Diabetes (no valve disease) |
No |
|
|
|
|
| Diabetes (valve disease) |
No |
|
|
Yes |
|
| Points |
|
5 |
6 |
7 |
8 |
9 |
| Age, y |
90-94 |
|
|
|
|
| Forced vital capacity, cL |
|
|
|
|
|
| Systolic blood pressure, mmHg |
|
|
|
|
|
| Heart rate, bpm |
|
|
|
|
|
| LVH on ECG |
Yes |
|
|
|
|
| Coronary Heart Disease |
|
|
|
|
|
| Cardiomegaly |
|
|
|
Yes |
|
| Valve Disease |
|
Yes |
|
|
|
| Diabetes (no valve disease) |
|
Yes |
|
|
|
| Diabetes (valve disease) |
|
|
|
|
|
| Points |
4-Year Probability, % |
Points |
4-Year Probability, % |
| 5 |
<1 |
26 |
18 |
| 10 |
1 |
27 |
21 |
| 12 |
1 |
28 |
24 |
| 14 |
2 |
29 |
28 |
| 16 |
3 |
30 |
32 |
| 18 |
4 |
31 |
37 |
| 20 |
6 |
32 |
42 |
| 22 |
9 |
33 |
46 |
| 24 |
13 |
34 |
51 |
| 25 |
15 |
35 |
56 |
*LVH indicates left ventricular hypertrophy; ECG, electrocardiogram.
Probability of Congestive Heart Failure Within 4 Years for
Women Aged 45 to 94 Years
With Coronary Disease, Hypertension, or Valvular Disease*
Model without vital capacity and chest x-ray results
| Points |
|
0 |
1 |
2 |
3 |
4 |
| Age, y |
45-49 |
50-54 |
55-59 |
60-64 |
65-69 |
| BMI, kg/m2 |
<21 |
21-25 |
26-29 |
>29 |
<150 |
| Systolic blood pressure, mmHg |
<140 |
140-209 |
>209 |
|
|
| Heart rate, bpm |
<60 |
60-79 |
80-104 |
>104 |
|
| LVH on ECG |
No |
|
|
|
|
| Coronary Heart Disease |
No |
|
|
|
|
| Valve Disease |
No |
|
|
|
|
| Diabetes (no valve disease) |
No |
|
|
|
|
| Diabetes (valve disease) |
No |
|
Yes |
|
|
| Points |
|
5 |
6 |
7 |
8 |
9 |
| Age, y |
70-74 |
75-79 |
80-84 |
85-89 |
90-94 |
| BMI, kg/m2 |
|
|
|
|
|
| Systolic blood pressure, mmHg |
|
|
|
|
|
| Heart rate, bpm |
|
|
|
|
|
| LVH on ECG |
Yes |
|
|
|
|
| Coronary Heart Disease |
|
Yes |
|
|
|
| Valve Disease |
|
Yes |
|
|
|
| Diabetes (no valve disease) |
|
Yes |
|
|
|
| Diabetes (valve disease) |
|
|
|
|
|
| Points |
4-Year Probability, % |
Points |
4-Year Probability, % |
| 5 |
<1 |
19 |
14 |
| 10 |
2 |
20 |
17 |
| 11 |
2 |
21 |
21 |
| 12 |
3 |
22 |
25 |
| 13 |
3 |
23 |
30 |
| 14 |
4 |
24 |
36 |
| 15 |
5 |
25 |
42 |
| 16 |
7 |
26 |
48 |
| 17 |
9 |
27 |
54 |
| 18 |
11 |
28 |
60 |
*LVH indicates left ventricular hypertrophy; ECG, electrocardiogram.
Pooled Logistic Regression Model With Coefficients
and Odds Ratios*
Model including vital capacity and chest x-ray information
| Variables |
Units |
Regression
Coefficient |
OR (95% CI) |
P |
| Men |
| Intercept |
|
-7.3611 |
|
|
| Age |
10 y |
0.0313 |
1.37 (1.17-1.60) |
<.001 |
| LVH |
Yes/no |
0.8428 |
2.32 (1.51-3.56) |
<.001 |
| Vital capacity |
100 cL |
-0.0030 0.74 |
(0.61-0.90) |
0.003 |
| Heart rate |
10 bpm |
0.0144 |
1.15 (1.05-1.27) |
0.002 |
| Systolic blood pressue |
20 mm Hg |
0.0067 |
1.14 (1.02-1.29) |
0.03 |
| CHD |
Yes/no |
1.5333 |
4.63 (3.52-6.10) |
<.001 |
| Valve disease |
Yes/no |
0.8868 |
2.43 (1.73-3.41) |
<.001 |
| Diabetes |
Yes/no |
0.2383 |
1.27 (0.90-1.79) |
0.17 |
| Cardiomegaly |
Yes/no |
0.7968 |
2.22 (1.63-3.01) |
<.001 |
| Women |
| Intercept |
|
-5.4997 |
|
|
| Age |
10 y |
0.0216 |
1.24 (1.06-1.45) |
0.007 |
| LVH |
Yes/no |
1.0072 |
2.74 (1.78-4.22) |
<.001 |
| Vital capacity |
100 cL |
-0.0087 |
0.42 (0.33-0.55) |
<.001 |
| Heart rate |
10 bpm |
0.0092 |
1.10 (0.99-1.21) |
0.07 |
| Systolic blood pressue |
20 mm Hg |
0.0032 |
1.07 (0.96-1.20) |
0.24 |
| CHD |
Yes/no |
1.5358 |
4.64 (3.42-6.31) |
<.001 |
| Valve disease |
Yes/no |
1.2454 |
3.47 (2.46-4.92) |
<.001 |
| Diabetes |
Yes/no |
1.4275 |
4.17 (2.91-5.97) |
<.001 |
| Cardiomegaly |
Yes/no |
0.4792 |
1.61 (1.21-2.16) |
0.001 |
| Valve disease and diabetes |
Yes/no |
-0.9293 |
0.39 (0.19-0.83) |
0.01 |
*OR indicates odds ratio; CI, confidence interval; LVH, left ventricular hypertrophy; and CHD,congenital heart disease.
Predicted probability of heart failure can be calculated as: p = 1/(1+exp(-xbeta)), where xbeta = Intercept + Sum (of regression coefficient*value of risk factor)
Pooled Logistic Regression Model With Coefficients
and Odds Ratios*
Model without vital capacity and chest x-ray information
| Variables |
Units |
Regression
Coefficient |
OR (95% CI) |
P |
| Men |
| Intercept |
|
-9.2087 |
|
|
| Age |
10 y |
0.0412 |
1.51 (1.31-1.74) |
<.001 |
| LVH |
Yes/no |
0.9026 |
2.47 (1.31-3.77) |
<.001 |
| Heart rate |
10 bpm |
0.0166 |
1.18 (1.08-1.29) |
<.001 |
| Systolic blood pressue |
20 mm Hg |
0.00804 |
1.17 (1.04-1.32) |
0.007 |
| CHD |
Yes/no |
1.6079 |
4.99 (3.80-6.55) |
<.001 |
| Valve disease |
Yes/no |
0.9714 |
2.64 (1.89-3.69) |
<.001 |
| Diabetes |
Yes/no |
0.2244 |
1.25 (0.89-1.76) |
0.2 |
| Women |
| Intercept |
|
-10.7988 |
|
|
| Age |
10 y |
0.0503 |
1.65 (1.42-1.93) |
<.001 |
| LVH |
Yes/no |
1.3402 |
3.82 (2.50-5.83) |
<.001 |
| Heart rate |
100 cL |
0.0105 |
1.11 (1.01-1.23) |
0.03 |
| Systolic blood pressure |
10 bpm |
0.00337 |
1.07 (0.96-1.20) |
0.24 |
| CHD |
20 mm Hg |
1.5549 |
4.74 (3.49-6.42) |
<.001 |
| Valve disease |
Yes/no |
1.3929 |
4.03 (2.86-5.67) |
<.001 |
| Diabetes |
Yes/no |
1.3857 |
4.00 (2.78-5.74) |
<.001 |
| BMI |
kg/m2 |
0.0578 |
1.06 (1.03-1.09) |
<.001 |
| Valve disease and diabetes |
Yes/no |
-0.9860 |
0.37 (0.18-0.78) |
0.009 |
*OR indicates odds ratio; CI, confidence interval; LVH, left ventricular hypertrophy;
CHD, congenital heart disease; and BMI, body mass index.
Predicted probability of heart failure can be calculated as: p = 1/(1+exp(-xbeta)),
where xbeta = Intercept + Sum (of regression coefficient*value of risk factor)
