Assessing the Utility of Test-Based Prediction Models: Heart Failure as an Example.

Chirinos et al.1 demonstrated that endotrophin levels are strongly associated with all-cause mortality and a composite outcome in patients with heart failure with preserved ejection fraction (HFpEF). The authors established the association in a subset of the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist)2 and validated it in external data sets. At a minimum, their observation is new knowledge that may advance our understanding of the pathophysiology of HFpEF. It also indicates that endotrophin-based risk prediction has utility for patients, the health system, and designing future research.