Abstract
Prediction of mortality risk in heart failure has evolved considerably since the 1990s. More than 100 risk factors and markers have been identified in various populations. Considerable differences in the importance of various factors exist between, for instance, inpatients and outpatients. Important biomarkers are measures of end-organ function, such as glomerular filtration rate or liver function tests. The importance of powerful cardiac biomarkers, such as natriuretic peptides, is reviewed. Novel markers such as frailty are becoming important in the comprehensive evaluation especially of elderly patients. In chronic advanced heart failure, exercise testing measuring peak oxygen uptake remains a cornerstone in the evaluation of risk, for instance, in patients referred for cardiac transplantation. Multivariable risk models increase the accuracy of risk prediction but cannot yet be relied upon as single tools for clinical decision making.
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