Key result
An AF risk score comprising 7 common clinical factors strongly predicted incident atrial fibrillation, achieving an area under the curve of 0.812 (95% CI, 0.805-0.820).
Why the study?
Does a clinical risk score predict the development of atrial fibrillation in an outpatient population?
Cohort (n=100,000)
Does a clinical risk score predict the development of atrial fibrillation in an outpatient population?
Effect estimate: AUC 0.812 (95% CI 0.805-0.820)
A simple clinical risk score based on 7 common factors can accurately predict the development of atrial fibrillation, potentially guiding patient selection for long-term monitoring.
May aid outpatient AF risk stratification; extends prior scores but leaves open need for prospective validation.
OBJECTIVE: To create a risk score using clinical factors to determine whom to screen and monitor for atrial fibrillation (AF). PATIENTS AND METHODS: The AF risk score was developed based on the summed odds ratios (ORs) for AF development of 7 accepted clinical risk factors. The AF risk score is intended to assess the risk of AF similar to how the CHA2DS2-VASc score assesses stroke risk. Seven validated risk factors for AF were used to develop the AF risk score: age, coronary artery disease, diabetes mellitus, sex, heart failure, hypertension, and valvular disease. The AF risk score was tested within a random population sample of the Intermountain Healthcare outpatient database. Outcomes were stratified by AF risk score for OR and Kaplan-Meier analysis. RESULTS: A total of 100,000 patient records with an index follow-up from January 1, 2002, through December 31, 2007, were selected and followed up for the development of AF through the time of this analysis, May 13, 2013, through September 6, 2013. Mean ± SD follow-up time was 3106±819 days. The ORs of subsequent AF diagnosis of patients with AF risk scores of 1, 2, 3, 4, and 5 or higher were 3.05, 12.9, 22.8, 34.0, and 48.0, respectively. The area under the curve statistic for the AF risk score was 0.812 (95% CI, 0.805-0.820). CONCLUSION: We developed a simple AF risk score made up of common clinical factors that may be useful to possibly select patients for long-term monitoring for AF detection.
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Brunner et al. (2014) conducted a cohort in Atrial fibrillation (n=100,000). AF risk score vs. Lower AF risk score was evaluated on Development of atrial fibrillation (AUC 0.812, 95% CI 0.805-0.820). An AF risk score comprising 7 common clinical factors strongly predicted incident atrial fibrillation, achieving an area under the curve of 0.812 (95% CI, 0.805-0.820).
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