C2HEST score predicts clinical outcomes in heart failure with preserved ejection fraction: a secondary analysis of the TOPCAT trial

Liang, Weihao; Wu, Yuzhong; Xue, Ruicong; Wu, Zexuan; Wu, Dexi; He, Jiangui; Dong, Yugang; Lip, Gregory Y. H.; Zhu, Wengen; Liu, Chen

doi:10.1186/s12916-021-01921-w

Table 2 Association of the C₂HEST score with AF and other outcomes in HFpEF patients

From: C₂HEST score predicts clinical outcomes in heart failure with preserved ejection fraction: a secondary analysis of the TOPCAT trial

Outcomes	Events	Person-years	Incidence rate, per 100 person-years	Unadjusted			Adjusted*
Outcomes	Events	Person-years	Incidence rate, per 100 person-years	HR	95% CI	P value	HR	95% CI	P value
AF
Overall**	130, 5.9%	7264	1.79	1.59	1.38–1.83	< 0.001	1.50	1.29–1.75	< 0.001
Risk strata
Low risk	39, 3.5%	3832	1.02	Ref.			Ref.
Medium risk	67, 7.3%	2902	2.31	2.18	1.47–3.24	< 0.001	2.00	1.34–2.99	< 0.001
High risk	24, 13.9%	529	4.54	4.04	2.44–6.71	< 0.001	3.32	1.93–5.71	< 0.001
Stroke
Overall**	52, 2.4%	7396	0.70	1.26	1.01–1.57	0.038	1.24	1.00–1.54	0.054
Risk strata
Low risk	20, 1.8%	3870	0.52	Ref.			Ref.
Medium risk	26, 2.8%	2977	0.87	1.64	0.91–2.95	0.097	1.59	0.90–2.79	0.110
High risk	6, 3.5%	550	1.09	1.92	0.77–4.77	0.160	1.77	0.71–4.39	0.220
All-cause death
Overall**	285, 12.9%	7485	3.81	1.35	1.22–1.49	< 0.001	1.20	1.08–1.33	< 0.001
Risk strata
Low risk	106, 9.5%	3899	2.72	Ref.			Ref.
Medium risk	135, 14.8%	3025	4.46	1.65	1.28–2.12	< 0.001	1.39	1.07–1.81	0.012
High risk	27, 15.6%	561	4.81	2.90	2.04–4.13	< 0.001	1.98	1.37–2.86	< 0.001
Cardiovascular death
Overall**	181, 8.2%	7485	2.42	1.25	1.09–1.43	0.001	1.15	1.00–1.33	0.058
Risk strata
Low risk	72, 6.5%	3899	1.85	Ref.			Ref.
Medium risk	82, 9.0%	3025	2.71	1.44	1.05–1.97	0.025	1.26	0.91–1.75	0.170
High risk	27, 15.6%	561	4.81	2.48	1.59–3.87	< 0.001	1.89	1.16–3.09	0.011
Any hospitalization
Overall**	865, 39.3%	5580	15.50	1.32	1.24–1.40	< 0.001	1.22	1.14–1.29	< 0.001
Risk strata
Low risk	349, 31.3%	3159	11.05	Ref.			Ref.
Medium risk	412, 45.1%	2075	19.86	1.65	1.43–1.90	< 0.001	1.50	1.30–1.73	< 0.001
High risk	104, 60.1%	346	30.06	2.41	1.94–3.00	< 0.001	1.87	1.47–2.37	< 0.001
HF hospitalization
Overall**	235, 10.7%	7072	3.32	1.29	1.16–1.45	< 0.001	1.14	1.01–1.29	0.036
Risk strata
Low risk	98, 8.8%	3732	2.63	Ref.			Ref.
Medium risk	100, 11.0%	2834	3.53	1.27	0.96–1.68	0.090	1.10	0.83–1.46	0.520
High risk	37, 21.4%	506	7.31	2.50	1.72–3.64	< 0.001	1.71	1.10–2.64	0.016

AF atrial fibrillation, HR hazard ratio, CI confidence interval
*Variables for adjustment: gender, treatment arm, diabetes mellitus, smoke or ever smoke, body mass index, heart rate, diastolic blood pressure, estimated glomerular filtration rate
**C₂HEST score was included as a continuous variable

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