A risk score for atrial fibrillation (AF) has been developed by the Framingham Heart
Study and Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE)-AF
consortium. However, validation of these risk scores in an inner-city population is
uncertain. Thus, a validation model was built using the Framingham Risk Score for
AF and CHARGE-AF covariates. An in and outpatient electrocardiographic database was
interrogated from 2000 to 2013 for the development of AF. Patients were included if
their age was >45 and <95 years, had <10-year follow-up, if their initial electrocardiogram
was without AF, had ≥2 electrocardiograms, and declared a race and/or ethnicity as
non-Hispanic white, African-American, or Hispanic. For the Framingham Heart Study,
49,599 patients met inclusion criteria, of which 4,860 developed AF. Discrimination
analysis using area under the curve (AUC) for original risk equations: non-Hispanic
white AUC = 0.712 (95% confidence interval [CI] 0.694 to 0.731), African-American
AUC = 0.733 (95% CI 0.716 to 0.751), and Hispanic AUC = 0.740 (95% CI 0.723 to 0.757).
For the CHARGE-AF, 45,571 patients met inclusion criteria, of which 4,512 developed
AF. Non-Hispanic white AUC = 0.673 (95% CI 0.652 to 0.694), African-American AUC =
0.706 (95% CI 0.685 to 0.727), and Hispanic AUC = 0.711 (95% CI 0.691 to 0.732). Calibration
analysis showed qualitative similarities between cohorts. In conclusion, this is the
first study to validate both the Framingham Heart Study and CHARGE-AF risk scores
in both a Hispanic and African-American cohort. All models predicted AF well across
all race and ethnic cohorts.
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Article Info
Publication History
Published online: October 16, 2015
Accepted:
October 9,
2015
Received in revised form:
October 9,
2015
Received:
July 30,
2015
Footnotes
See page 82 for disclosure information.
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
