| 描述信息 |
To construct a multi-mRNA signature to predict 1-year all-cause death in hospitalized patients with HFpEF, we performed whole genome mRNA microarray in 3 independent datasets of HFpEF. In the discovery set, we selected 30 HFpEF patients who died during 1-year follow-up as cases, and 30 HFpEF patients who survived as controls. In the test and validation sets, we used a prospective cohort design including 171 and 120 randomly selected patients, respectively, from the China PEACE 5p-HF Study. We first identified candidate genes associated with 1-year all-cause death in the discovery and test sets, which were used to perform a LASSO regression. After that, the mRNAs screened by LASSO regression were used to construct a multi-mRNA signature by Cox regression model in the test set. Finally, the multi-mRNA signature was evaluated and validated in the test and validation sets. We constructed a 5-mRNA signature for predicting 1-year all-cause death. The scores of the 5-mRNA signature were significantly associated with the 1-year risk of all-cause death in both the test set (HR=2.72, 95% CI 1.98-3.74, p<0.001) and the validation set (HR=3.95, 95% CI 2.40-6.48, p<0.001). Compared to a reference model which included gender, ASCEND-HF score, history of HF and NT-proBNP, the 5-mRNA signature had a better discrimination capability, with an increased area under the curve (AUC) from 0.696 to 0.813 in the test set and from 0.712 to 0.848 in the validation set. A composite model integrating the 5-mRNA risk score and variables in the reference model demonstrated an excellent discrimination capability, with an AUC of 0.861 (95% CI 0.784-0.939) in the test set and an AUC of 0.859 (95% CI 0.755-0.963) in the validation set. The 5-mRNA signature is a promising predictive factor for 1-year all-cause death and shows improved prognostic power over the established risk scores and NT-proBNP in the HFpEF patients. |
