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SMART-CHOICE HF Subpopulation Algorithm

  • Age (years)
  • Sex
  • Left Ventricular Ejection Fraction (LVEF, %)
  • NYHA class
  • Systolic BP (mmHg)
  • Heart rate (bpm)
  • Serum creatinine (mg/dL)
  • Serum sodium (mmol/L)
  • Diabetes mellitus
  • Chronic obstructive pulmonary disease (COPD)
  • Current smoker
  • SMART-CHOICE HF Subpopulation Algorithm — explanation and clinical context
    This tool classifies heart failure patients into subpopulations using commonly accepted left ventricular ejection fraction thresholds (HFrEF <41%, HFmrEF 41–49%, HFpEF ≥50%). It then provides directional prognostic information using two well-known validated frameworks as proxies: the MAGGIC risk framework for 1- and 3-year mortality, and the GWTG-HF model for in-hospital mortality risk. The MAGGIC and GWTG-HF models are validated prognostic tools developed from large international or registry cohorts and use multiple clinical variables (age, EF, NYHA, comorbidities, renal function, electrolytes, vital signs) to estimate mortality risk. The outputs shown here are approximate because reproducing the exact original models requires the published coefficients/point tables; if you provide the SMART-CHOICE HF publication or coefficient table I will implement the exact original model to produce precise numeric risk predictions.

    Clinical interpretation summary: Use the LVEF-based subpopulation to guide phenotype-specific management (e.g., guideline-directed medical therapy and device considerations differ for HFrEF vs HFpEF). Use the approximate mortality categories here only as an initial orientation; confirm with validated calculators or original model output for individual patient decisions.

    References:
    1) Meta-Analysis Global Group In Chronic Heart Failure (MAGGIC) risk score — development and validation of a multivariable risk model for mortality in heart failure. (See MAGGIC risk literature and validated calculators such as MDCalc.).
    2) Get With The Guidelines — Heart Failure (GWTG-HF) risk score for in-hospital mortality. Original description and validation.
    3) I was unable to find a peer-reviewed publication describing a dedicated “SMART-CHOICE HF Subpopulation Algorithm” (search results for SMART-CHOICE mainly refer to antiplatelet SMART-CHOICE trials). If you have the SMART-CHOICE HF manuscript, supplementary material, or coefficient table, please paste it and I will implement the original model exactly.

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