Sex-stratified early biomarker model identifies lactate as the key predictor of in-hospital deterioration in acute heart failure.

A significant trend was observed across strata (Spearman rho = 0.257, p = 0.002), highlighting the clinical relevance of lactate thresholds in early risk assessment. 3.7 Model stability (EPV analysis) Events-per-variable (EPV) calculations are shown in Supplementary Table S8 .

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Killip class showed directional associations with higher deterioration risk but did not reach statistical significance in this dataset.

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