USING BIOMARKER INFORMATION FOR HEART FAILURE RISK COMPUTATION
Provided is a method, system and/or apparatus for determining prospective heart failure event risk. Acquired from a device memory are a heart failure patient's current and preceding risk assessment periods. Counting detected data observations in the current risk assessment period for a current risk assessment total amount and counting detected data observations in the preceding risk assessment period for a preceding risk assessment period total amount. Associating the current risk assessment and preceding risk assessment total amounts with a lookup table to acquire prospective risk of heart failure (HF) event for the preceding risk assessment period and the current risk assessment period. Employing weighted sums of the prospective risk of the HF event for the preceding risk assessment period and the current risk assessment period to calculate a weighted prospective risk of the HF event for a patient. Displaying on a graphical user interface the weighted prospective risk of the HF event for the patient.
1 . (canceled)
2 . A medical system comprising:
an implantable sensor;
a processor configured to:
monitor multiple parameters associated with worsening heart failure, the multiple parameters comprising:
at least one parameter received from the implantable sensor, and
biomarker information comprising brain natriuretic peptide (BNP), precursor of BNP, N-terminus ProBNP (NT-proBNP), creatinine, serum K+, Serum Na+, hemoglobin, hematocrit, calcium, creatine, phosphokinase, troponin, glucose, blood urea nitrogen (BUN), Cystatin C, or any combination thereof; and
derive, based on the multiple diagnostic parameters and using a Bayesian approach, a prospective risk of heart failure hospitalization; and
a graphical user interface responsive to the processor and configured to display the derived prospective risk of heart failure hospitalization.
3 . The system of claim 2 , wherein the biomarker information is acquired from a database configured to receive patient data.
4 . The system of claim 2 , wherein the biomarker information is acquired from an implantable medical device.
5 . The system of claim 2 , wherein the processor is further configured to:
use the derived prospective risk of heart failure hospitalization to modify therapy delivered by an implantable medical device; and
deliver, using the implantable medical device, or transmit, using a telemetry module, the modified therapy.
6 . The system of claim 5 , wherein the biomarker information is obtained from the implantable medical device.
7 . The system of claim 5 , wherein using the derived prospective risk of heart failure hospitalization to modify the therapy delivered by the implantable medical device comprises using the derived prospective risk of heart failure hospitalization to modify therapy delivered by administering an agent or adjusting an agent delivered to a patient.
8 . The system of claim 5 , wherein using the derived prospective risk of heart failure hospitalization to modify the therapy delivered by the implantable medical device comprises using the derived prospective risk of heart failure hospitalization to switch from a first pacing therapy delivered by the implantable medical device to a second pacing therapy.
9 . The system of claim 8 , wherein the second pacing therapy comprises one or more of biventricular pacing, fusion pacing, and multisite pacing.
10 . The system of claim 2 , wherein the at least one parameter received from the implantable sensor comprises at least one of an intrathoracic impedance, a thoracic fluid index, an atrial fibrillation duration after cardioversion therapy, a heart rate variability, an elevation of ventricular rate during persistent atrial fibrillation, an elevation of night heart rate, and a cardiac resynchronization therapy percentage.
11 . The system of claim 2 , wherein the processor is configured to derive, based on the multiple diagnostic parameters and using the Bayesian approach, the prospective risk of heart failure hospitalization in real-time while in an ambulatory setting.
12 . A method of operating a medical system, the method comprising:
monitoring multiple parameters associated with worsening heart failure, the multiple parameters comprising:
at least one parameter received from an implantable sensor, and
biomarker information comprising brain natriuretic peptide (BNP), precursor of BNP, N-terminus ProBNP (NT-proBNP), creatinine, serum K+, Serum Na+, hemoglobin, hematocrit, calcium, creatine, phosphokinase, troponin, glucose, blood urea nitrogen (BUN), Cystatin C, or any combination thereof;
deriving, based on the multiple diagnostic parameters and using a Bayesian approach, a prospective risk of heart failure hospitalization; and
displaying, using a graphical user interface, the derived prospective risk of heart failure hospitalization.
13 . The method of claim 12 , further comprising acquiring, from a database configured to receive patient data, the biomarker information.
14 . The method of claim 12 , further comprising acquiring, from an implantable medical device, the biomarker information.
15 . The method of claim 12 , further comprising:
modifying, using the derived prospective risk of heart failure hospitalization, therapy delivered by an implantable medical device; and
delivering or transmitting the modified therapy.
16 . The method of claim 15 , further comprising acquiring, from the implantable medical device, the biomarker information.
17 . The method of claim 15 , wherein modifying, using the derived prospective risk of heart failure hospitalization, the therapy delivered by the implantable medical device comprises modifying, using the derived prospective risk of heart failure hospitalization, therapy delivered by administering an agent or adjusting an agent delivered to a patient.
18 . The method of claim 15 , wherein modifying, using the derived prospective risk of heart failure hospitalization, the therapy delivered by the implantable medical device comprises switching from a first pacing therapy delivered by the implantable medical device to a second pacing therapy.
19 . The method of claim 18 , wherein the second pacing therapy comprises one or more of biventricular pacing, fusion pacing, and multisite pacing.
20 . The method of claim 12 , wherein the at least one parameter received from the implantable sensor comprises at least one of an intrathoracic impedance, a thoracic fluid index, an atrial fibrillation duration after cardioversion therapy, a heart rate variability, an elevation of ventricular rate during persistent atrial fibrillation, an elevation of night heart rate, and a cardiac resynchronization therapy percentage.
21 . The method of claim 12 , wherein deriving, based on the multiple diagnostic parameters and using the Bayesian approach, the prospective risk of heart failure hospitalization comprises deriving in real-time while in an ambulator setting, based on the multiple diagnostic parameters and using the Bayesian approach, the prospective risk of heart failure hospitalization.