Risk Stratification Towards Precision Medicine in Heart Failure　― Current Progress and Future Perspectives ―

• Nagai Toshiyuki

  Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

• Nakao Motoki

  Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

• Anzai Toshihisa

  Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

Abstract

Clinical risk stratification is a key strategy used to identify low- and high-risk subjects to optimize the management, ranging from pharmacological treatment to palliative care, of patients with heart failure (HF). Using statistical modeling techniques, many HF risk prediction models that combine predictors to assess the risk of specific endpoints, including death or worsening HF, have been developed. However, most risk prediction models have not been well-integrated into the clinical setting because of their inadequacy and diverse predictive performance. To improve the performance of such models, several factors, including optimal sampling and biomarkers, need to be considered when deriving the models; however, given the large heterogeneity of HF, the currently advocated one-size-fits-all approach is not appropriate for every patient. Recent advances in techniques to analyze biological “omics” information could allow for the development of a personalized medicine platform, and there is growing awareness that an integrated approach based on the concept of system biology may be an excessively naïve view of the multiple contributors and complexity of an individual’s HF phenotype. This review article describes the progress in risk stratification strategies and perspectives of emerging precision medicine in the field of HF management.

Journal

• Circulation Journal

  Circulation Journal 85 (5), 576-583, 2021-04-23

  The Japanese Circulation Society

Keywords

• Omics
• Phenotyping
• Precision medicine
• Prediction model
• Risk stratification

Details

• CRID: 1390569258153244672
• NII Article ID: 130008028993
• NII Book ID: AA11591968
• DOI: 10.1253/circj.cj-20-1299
• ISSN: 13474820
• ISSN: 13469843
• NDL BIB ID: 031419578
• PubMed: 33658445
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I031419578
• Web Site: https://www.jstage.jst.go.jp/article/circj/85/5/85_CJ-20-1299/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2022073716
• Text Lang: en
• Data Source:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed