Key result
Every one-point increase in the C2HEST score was associated with a 3% increased risk of atrial fibrillation (OR 1.03), with an overall area under the curve of 0.91 for predicting AF.
Why the study?
This meta-analysis aimed to assess the value of the C2HEST score to facilitate population screening and detection of AF risk, and validate its discriminatory power for identifying people at high or low risk.
Does the C2HEST score accurately predict the risk of incident atrial fibrillation in the general population and patients with chronic conditions?
Meta-Analysis (n=9,035,572)
Does the C2HEST score accurately predict the risk of incident atrial fibrillation in the general population and patients with chronic conditions?
Odds Ratio: 1.03 (95% CI 1.01–1.05)
p-value: p=<0.00001
The C2HEST score demonstrates high diagnostic accuracy (AUC 0.91) for predicting incident atrial fibrillation, supporting its use as a rapid risk assessment tool for population screening.
Background This meta-analysis aimed to assess the value of the C 2 HEST score to facilitate population screening and detection of AF risk in millions of populations and validate risk scores and their composition and discriminatory power for identifying people at high or low risk of AF. We searched major indexing databases, including Pubmed/Medline, ISI web of science, Scopus, Embase, and Cochrane central, using (“C2HEST” OR “risk scoring system” OR “risk score”) AND (“atrial fibrillation (AF)” OR “atrial flutter” OR “tachycardia, supraventricular” OR “heart atrium flutter”) without any language, study region or study type restrictions between 1990 and 2021 years. Analyses were done using Meta-DiSc. The title and abstract screening were conducted by two independent investigators. Results Totally 679 records were found through the initial search, of which ultimately, nine articles were included in the qualitative and quantitative analyses. The risk of AF accompanied every one-point increase of C 2 HEST score (OR 1.03, 95% CI 1.01–1.05, p < 0.00001), with a high heterogeneity across studies ( I 2 = 100%). The SROC for C 2 HEST score in the prediction of AF showed that the overall area under the curve (AUC) was 0.91 (95% CI 0.85–0.96), AUC in Asian population was 0.87 (95% CI: 0.78–0.95) versus non-Asian 0.95 (95% CI 0.91–0.99), and in general population was 0.92 (95% CI 0.85–0.99) versus those with chronic conditions 0.83 (95% CI 0.71–0.95), respectively. Conclusions The results of this research support the idea that this quick score has the opportunity for use as a risk assessment in patients' AF screening strategies.
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Haybar et al. (2021) conducted a meta-analysis in Atrial fibrillation risk prediction (n=9,035,572). C2HEST score was evaluated on Risk of atrial fibrillation per one-point increase in C2HEST score (OR 1.03, 95% CI 1.01-1.05, p=<0.00001). Every one-point increase in the C2HEST score was associated with a 3% increased risk of atrial fibrillation (OR 1.03), with an overall area under the curve of 0.91 for predicting AF.
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