Skip to main content
Journal cover image

Validation of the WATCH-DM and TRS-HFDM Risk Scores to Predict the Risk of Incident Hospitalization for Heart Failure Among Adults With Type 2 Diabetes: A Multicohort Analysis.

Publication ,  Journal Article
Segar, MW; Patel, KV; Hellkamp, AS; Vaduganathan, M; Lokhnygina, Y; Green, JB; Wan, S-H; Kolkailah, AA; Holman, RR; Peterson, ED; Kannan, V ...
Published in: J Am Heart Assoc
June 7, 2022

Background The WATCH-DM (weight [body mass index], age, hypertension, creatinine, high-density lipoprotein cholesterol, diabetes control [fasting plasma glucose], ECG QRS duration, myocardial infarction, and coronary artery bypass grafting) and TRS-HFDM (Thrombolysis in Myocardial Infarction [TIMI] risk score for heart failure in diabetes) risk scores were developed to predict risk of heart failure (HF) among individuals with type 2 diabetes. WATCH-DM was developed to predict incident HF, whereas TRS-HFDM predicts HF hospitalization among patients with and without a prior HF history. We evaluated the model performance of both scores to predict incident HF events among patients with type 2 diabetes and no history of HF hospitalization across different cohorts and clinical settings with varying baseline risk. Methods and Results Incident HF risk was estimated by the integer-based WATCH-DM and TRS-HFDM scores in participants with type 2 diabetes free of baseline HF from 2 randomized clinical trials (TECOS [Trial Evaluating Cardiovascular Outcomes With Sitagliptin], N=12 028; and Look AHEAD [Look Action for Health in Diabetes] trial, N=4867). The integer-based WATCH-DM score was also validated in electronic health record data from a single large health care system (N=7475). Model discrimination was assessed by the Harrell concordance index and calibration by the Greenwood-Nam-D'Agostino statistic. HF incidence rate was 7.5, 3.9, and 4.1 per 1000 person-years in the TECOS, Look AHEAD trial, and electronic health record cohorts, respectively. Integer-based WATCH-DM and TRS-HFDM scores had similar discrimination and calibration for predicting 5-year HF risk in the Look AHEAD trial cohort (concordance indexes=0.70; Greenwood-Nam-D'Agostino P>0.30 for both). Both scores had lower discrimination and underpredicted HF risk in the TECOS cohort (concordance indexes=0.65 and 0.66, respectively; Greenwood-Nam-D'Agostino P<0.001 for both). In the electronic health record cohort, the integer-based WATCH-DM score demonstrated a concordance index of 0.73 with adequate calibration (Greenwood-Nam-D'Agostino P=0.96). TRS-HFDM score could not be validated in the electronic health record because of unavailability of data on urine albumin/creatinine ratio in most patients in the contemporary clinical practice. Conclusions The WATCH-DM and TRS-HFDM risk scores can discriminate risk of HF among intermediate-risk populations with type 2 diabetes.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

June 7, 2022

Volume

11

Issue

11

Start / End Page

e024094

Location

England

Related Subject Headings

  • Risk Factors
  • Risk Assessment
  • Myocardial Infarction
  • Humans
  • Hospitalization
  • Heart Failure
  • Diabetes Mellitus, Type 2
  • Creatinine
  • Adult
  • 3201 Cardiovascular medicine and haematology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Segar, M. W., Patel, K. V., Hellkamp, A. S., Vaduganathan, M., Lokhnygina, Y., Green, J. B., … Pandey, A. (2022). Validation of the WATCH-DM and TRS-HFDM Risk Scores to Predict the Risk of Incident Hospitalization for Heart Failure Among Adults With Type 2 Diabetes: A Multicohort Analysis. J Am Heart Assoc, 11(11), e024094. https://doi.org/10.1161/JAHA.121.024094
Segar, Matthew W., Kershaw V. Patel, Anne S. Hellkamp, Muthiah Vaduganathan, Yuliya Lokhnygina, Jennifer B. Green, Siu-Hin Wan, et al. “Validation of the WATCH-DM and TRS-HFDM Risk Scores to Predict the Risk of Incident Hospitalization for Heart Failure Among Adults With Type 2 Diabetes: A Multicohort Analysis.J Am Heart Assoc 11, no. 11 (June 7, 2022): e024094. https://doi.org/10.1161/JAHA.121.024094.
Segar MW, Patel KV, Hellkamp AS, Vaduganathan M, Lokhnygina Y, Green JB, et al. Validation of the WATCH-DM and TRS-HFDM Risk Scores to Predict the Risk of Incident Hospitalization for Heart Failure Among Adults With Type 2 Diabetes: A Multicohort Analysis. J Am Heart Assoc. 2022 Jun 7;11(11):e024094.
Segar, Matthew W., et al. “Validation of the WATCH-DM and TRS-HFDM Risk Scores to Predict the Risk of Incident Hospitalization for Heart Failure Among Adults With Type 2 Diabetes: A Multicohort Analysis.J Am Heart Assoc, vol. 11, no. 11, June 2022, p. e024094. Pubmed, doi:10.1161/JAHA.121.024094.
Segar MW, Patel KV, Hellkamp AS, Vaduganathan M, Lokhnygina Y, Green JB, Wan S-H, Kolkailah AA, Holman RR, Peterson ED, Kannan V, Willett DL, McGuire DK, Pandey A. Validation of the WATCH-DM and TRS-HFDM Risk Scores to Predict the Risk of Incident Hospitalization for Heart Failure Among Adults With Type 2 Diabetes: A Multicohort Analysis. J Am Heart Assoc. 2022 Jun 7;11(11):e024094.
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

June 7, 2022

Volume

11

Issue

11

Start / End Page

e024094

Location

England

Related Subject Headings

  • Risk Factors
  • Risk Assessment
  • Myocardial Infarction
  • Humans
  • Hospitalization
  • Heart Failure
  • Diabetes Mellitus, Type 2
  • Creatinine
  • Adult
  • 3201 Cardiovascular medicine and haematology