A risk score for atrial fibrillation (AF) has been developed by the Framingham Heart
Study; however, the applicability of this risk score, derived using data from white
patients, to predict new-onset AF in nonwhites is uncertain. Therefore, we developed
a 10-year risk score for new-onset AF from risk factors commonly measured in clinical
practice using 14,546 subjects from the Atherosclerosis Risk In Communities (ARIC)
study, a prospective community-based cohort of blacks and whites in the United States.
During 10 years of follow-up, 515 incident AF events occurred. The following variables
were included in the AF risk score: age, race, height, smoking status, systolic blood
pressure, hypertension medication use, precordial murmur, left ventricular hypertrophy,
left atrial enlargement, diabetes, coronary heart disease, and heart failure. The
area under the receiver operating characteristics curve (AUC) of a Cox regression
model that included the previous variables was 0.78, suggesting moderately good discrimination.
The point-based score developed from the coefficients in the Cox model had an AUC
of 0.76. This clinical risk score for AF in the Atherosclerosis Risk In Communities
cohort compared favorably with the Framingham Heart Study's AF (AUC 0.68), coronary
heart disease (CHD) (AUC 0.63), and hard CHD (AUC 0.59) risk scores and the Atherosclerosis
Risk In Communities CHD risk score (AUC 0.58). In conclusion, we have developed a
risk score for AF and have shown that the different pathophysiologies of AF and CHD
limit the usefulness of a CHD risk score in identifying subjects at greater risk of
AF.
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Article Info
Publication History
Accepted:
August 17,
2010
Received in revised form:
August 17,
2010
Received:
June 7,
2010
Footnotes
The Atherosclerosis Risk In Communities Study was performed as a collaborative study supported by Grants N01-HC-55015 , N01-HC-55016 , N01-HC-55018 , N01-HC-55019 , N01-HC-55020 , N01-HC-55021 , and N01-HC-55022 from the National Heart, Lung, and Blood Institute , Bethesda, Maryland. Dr. Chamberlain was supported by Grant T32-HL-007779 from the National Heart, Lung, and Blood Institute , Bethesda, Maryland. This study was further supported by Grant 09SDG2280087 from the American Heart Association , Dallas, Texas, and Grants RC1HL099452 and RC1HL101056 from National Heart, Lung, and Blood Institute , Bethesda, Maryland.
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