Use of CHA₂DS₂-VASc Score to Predict New-Onset Atrial Fibrillation in Chronic Obstructive Pulmonary Disease Patients　― Large-Scale Longitudinal Study ―

BACKGROUND The aim of this study was to assess the accuracy of CHA2DS2-VASc score in predicting new-onset atrial fibrillation (AF) in patients with chronic obstructive pulmonary disease (COPD).Methods and Results:A total of 50,430 COPD patients were enrolled in this study. The area under the receiver operating characteristic curve (AUC) and the Cox model c-statistic were used to assess the association between new-onset AF risk and CHA2DS2-VASc score in COPD patients. After adjustment for comorbidities other than the components of CHA2DS2-VASc score, risk of new-onset AF in COPD patients increased from 1.24 (95% confidence interval (CI): 1.01-1.52) for a score of 1, to 2.15 (95% CI: 1.62-2.86) for score ≥6 (trend test, P<0.001), compared with CHA2DS2-VASc score 0. The AUC for CHA2DS2-VASc score in predicting new-onset AF in COPD patients was 0.69 (95% CI: 0.68-0.70). The c-statistic of Cox model in predicting incident AF was 0.73. CONCLUSIONS Risk of new-onset AF in COPD patients increased with increasing CHA2DS2-VASc score. The predictive ability of the score was moderate. CHA2DS2-VASc score might be used as a screening tool for AF in COPD patients.