Lang, Chim C.

Streng, Koen W.

Voors, Adriaan A.

Proceedings - University of Groningen

   University of GroningenWhat is the added value of the waist-to-hip ratio on top of the BIOSTAT-CHF risk predictionmodel in patients with heart failure?Streng, Koen W.; Lang, Chim C.; Voors, Adriaan A.Published in:European Journal of Heart FailureDOI:10.1002/ejhf.1303IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2019Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Streng, K. W., Lang, C. C., & Voors, A. A. (2019). What is the added value of the waist-to-hip ratio on top ofthe BIOSTAT-CHF risk prediction model in patients with heart failure? European Journal of Heart Failure,21(1), 132. https://doi.org/10.1002/ejhf.1303CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum..................................................................................................................................................................................................................LETTERS TO THE EDITORdoi:10.1002/ejhf.1303Online publish-ahead-of-print 23 August 2018What is the added value ofthe waist-to-hip ratio on topof the BIOSTAT-CHF riskprediction model in patientswith heart failure?I read with great interest the article by Strenget al.1 published in the European Journal ofHeart Failure. I congratulate the authors for asolid study design and very exciting results.Streng et al. conducted a very valuable studywhere 1479 patients with waist and hipmeasurements from the BIOlogy Study toTAilored Treatment in Chronic Heart Failure(BIOSTAT-CHF) validation cohort wereanalysed.2 The authors found that there wasa significant association between waist-to-hip ratio (WHR) and mortality in womenwith heart failure (HF). In addition, their datademonstrated that a higher WHR was relatedto an elevation of inflammatory markers andmitogen-activated protein kinase cascade inwomen. The findings in this study suggest thatfat deposition is involved with pathogenesisand may be a therapeutic target in femalepatients with HF.1 However, the study designof the BIOSTAT-CHF project was exclusivefor Caucasian patients.2 Therefore, furtherstudies might be required in other ethnicitiesand geographic regions. Furthermore, theauthors have recently developed and validateda risk prediction model for patients with HFfrom the BIOSTAT-CHF population3 thatuses an online calculator available at: http://www.biostat-chf.eu. The risk scores are cal-culated based on age, HF hospitalisation in thelast year, peripheral oedema, systolic bloodpressure, N-terminal pro-B-type natriureticpeptide, haemoglobin, high-density lipopro-tein, serum sodium and beta-blocker use atbaseline. Could Streng et al. do a further anal-ysis for this BIOSTAT-CHF validation cohortto discover the added value of WHR on topof the BIOSTAT-CHF risk prediction model,especially in women if it is possible? Thiswould have a greater impact for this study.Finally, adiposity has been associated withincreased concentrations of proinflammatorycytokines such as tumour necrosis factor-𝛼,interleukin-6 and C-reactive protein (CRP).4In particular, higher CRP levels in plasmawere associated with more severe HF, mor-bidity and mortality.5 However, no dataabout CRP were presented in the article.If the authors could report the data aboutCRP, this would be more informative forreaders.Conflict of interest: T.H.C. is funded by theJohn and Lucille van Geest Foundation and theNational Institute for Health Research Leices-ter Biomedical Research Centre.Thong Huy Cao∗University of Leicester, Department ofCardiovascular Sciences, National Institute forHealth Research Leicester BiomedicalResearch Centre, Glenfield Hospital,Leicester, UK*Email: tch10@le.ac.ukReferences1. Streng KW, Voors AA, Hillege HL, Anker SD, Cle-land JG, Dickstein K, Filippatos G, Metra M, Ng LL,Ponikowski P, Samani NJ, van Veldhuisen DJ, Zwin-derman AH, Zannad F, Damman K, van der Meer P,Lang CC. Waist-to-hip ratio and mortality in heartfailure. Eur J Heart Fail 2018;20:1269–1277.2. Voors AA, Anker SD, Cleland JG, Dickstein K, Fil-ippatos G, van der Harst P, Hillege HL, Lang CC,Ter Maaten JM, Ng L, Ponikowski P, Samani NJ, vanVeldhuisen DJ, Zannad F, Zwinderman AH, MetraM. A systems BIOlogy Study to TAilored Treatmentin Chronic Heart Failure: rationale, design, and base-line characteristics of BIOSTAT-CHF. Eur J Heart Fail2016;18:716–726.3. Voors AA, Ouwerkerk W, Zannad F, van VeldhuisenDJ, Samani NJ, Ponikowski P, Ng LL, Metra M, terMaaten JM, Lang CC, Hillege HL, van der Harst P, Fil-ippatos G, Dickstein K, Cleland JG, Anker SD, Zwin-derman AH. Development and validation of multi-variable models to predict mortality and hospital-ization in patients with heart failure. Eur J Heart Fail2017;19:627–634.4. Bahceci M, Gokalp D, Bahceci S, Tuzcu A, AtmacS, Arikan S. The correlation between adiposityand adiponectin, tumor necrosis factor alpha,interleukin-6 and high sensitivity C-reactive proteinlevels: is adipocyte size associated with inflam-mation in adults? J Endocrinol Invest 2007;30:210–214.5. Anand IS, Latini R, Florea VG, Kuskowski MA,Rector T, Masson S, Signorini S, Mocarelli P, HesterA, Glazer R, Cohn JN; Val-HeFT Investigators.C-reactive protein in heart failure: prognos-tic value and the effect of valsartan. Circulation2005;112:1428–1434.© 2018 The AuthorsEuropean Journal of Heart Failure © 2018 European Society of Cardiology

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What is the added value of the waist-to-hip ratio on top of the BIOSTAT-CHF risk prediction model in patients with heart failure?

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What is the added value of the waist-to-hip ratio on top of the BIOSTAT-CHF risk prediction model in patients with heart failure?

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University of Groningen

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Proceedings - University of Groningen

ARTS repository - University of Groningen

ARTS repository - University of Groningen

Dissertations of the University of Groningen

University of Groningen