Yoshihiro Kokubo1, Makoto Watanabe1, Aya Higashiyama2, Yoko M Nakao2, Kengo Kusano3, Yoshihiro Miyamoto1,2. 1. Department of Preventive Medicine, National Cerebral and Cardiovascular Center. 2. Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center. 3. Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center.
Abstract
BACKGROUND: An atrial fibrillation (AF) risk score for a non-Western general population has not been established.Methods and Results: A total of 6,898 participants (30-79 years old) initially free of AF have been prospectively followed for incident AF since 1989. AF was diagnosed when AF or atrial flutter was present on ECG at a biannual health examination; was indicated as a current illness; or was in the medical records during follow-up. Cox proportional hazard ratios were analyzed after adjusting for cardiovascular risk factors at baseline. During the 95,180 person-years of follow-up, 311 incident AF events occurred. We developed a scoring system for each risk factor as follows: 0/-5, 3/0, 7/5, and 9/9 points for men/women in their 30 s-40 s, 50 s, 60 s, and 70 s, respectively; 2 points for systolic hypertension, overweight, excessive drinking, or coronary artery disease; 1 point for current smoking; -1 point for moderate non-high-density lipoprotein-cholesterol; 4 points for arrhythmia; and 8, 6, and 2 points for subjects with cardiac murmur in their 30 s-40 s, 50 s, and 60 s, respectively (C-statistic 0.749; 95% confidence interval, 0.724-0.774). Individuals with score ≤2, 10-11, or ≥16 points had, respectively, ≤1%, 9%, and 27% observed probability of developing AF in 10 years. CONCLUSIONS: We developed a 10-year risk score for incident AF using traditional risk factors that are easily obtained in routine outpatient clinics/health examinations without ECG.
BACKGROUND: An atrial fibrillation (AF) risk score for a non-Western general population has not been established.Methods and Results: A total of 6,898 participants (30-79 years old) initially free of AF have been prospectively followed for incident AF since 1989. AF was diagnosed when AF or atrial flutter was present on ECG at a biannual health examination; was indicated as a current illness; or was in the medical records during follow-up. Cox proportional hazard ratios were analyzed after adjusting for cardiovascular risk factors at baseline. During the 95,180 person-years of follow-up, 311 incident AF events occurred. We developed a scoring system for each risk factor as follows: 0/-5, 3/0, 7/5, and 9/9 points for men/women in their 30 s-40 s, 50 s, 60 s, and 70 s, respectively; 2 points for systolic hypertension, overweight, excessive drinking, or coronary artery disease; 1 point for current smoking; -1 point for moderate non-high-density lipoprotein-cholesterol; 4 points for arrhythmia; and 8, 6, and 2 points for subjects with cardiac murmur in their 30 s-40 s, 50 s, and 60 s, respectively (C-statistic 0.749; 95% confidence interval, 0.724-0.774). Individuals with score ≤2, 10-11, or ≥16 points had, respectively, ≤1%, 9%, and 27% observed probability of developing AF in 10 years. CONCLUSIONS: We developed a 10-year risk score for incident AF using traditional risk factors that are easily obtained in routine outpatient clinics/health examinations without ECG.
Authors: Bryce Alexander; Julia Milden; Bachar Hazim; Sohaib Haseeb; Antoni Bayes-Genis; Roberto Elosua; Manuel Martínez-Sellés; Cynthia Yeung; Wilma Hopman; Antoni Bayes de Luna; Adrian Baranchuk Journal: Ann Noninvasive Electrocardiol Date: 2019-06-11 Impact factor: 1.468