Clinical Predictors of Risk for Atrial Fibrillation: Implications for Diagnosis and Monitoring

doi:10.1016/j.mayocp.2014.08.016

Mayo Clinic Proceedings

Volume 89, Issue 11, November 2014, Pages 1498-1505

https://doi.org/10.1016/j.mayocp.2014.08.016 Get rights and content

Under a Creative Commons license

open access

Abstract

Objective

To create a risk score using clinical factors to determine whom to screen and monitor for atrial fibrillation (AF).

Patients and Methods

The AF risk score was developed based on the summed odds ratios (ORs) for AF development of 7 accepted clinical risk factors. The AF risk score is intended to assess the risk of AF similar to how the CHA₂DS₂-VASc score assesses stroke risk. Seven validated risk factors for AF were used to develop the AF risk score: age, coronary artery disease, diabetes mellitus, sex, heart failure, hypertension, and valvular disease. The AF risk score was tested within a random population sample of the Intermountain Healthcare outpatient database. Outcomes were stratified by AF risk score for OR and Kaplan-Meier analysis.

Results

A total of 100,000 patient records with an index follow-up from January 1, 2002, through December 31, 2007, were selected and followed up for the development of AF through the time of this analysis, May 13, 2013, through September 6, 2013. Mean ± SD follow-up time was 3106±819 days. The ORs of subsequent AF diagnosis of patients with AF risk scores of 1, 2, 3, 4, and 5 or higher were 3.05, 12.9, 22.8, 34.0, and 48.0, respectively. The area under the curve statistic for the AF risk score was 0.812 (95% CI, 0.805-0.820).

Conclusion

We developed a simple AF risk score made up of common clinical factors that may be useful to possibly select patients for long-term monitoring for AF detection.

Abbreviations and Acronyms

atrial fibrillation

ASSERT

Asymptomatic Atrial Fibrillation and Stroke Evaluation in Pacemaker Patients and the Atrial Fibrillation Reduction Atrial Pacing Trial

ICD-9

International Classification of Diseases, Ninth Revision

odds ratio

Cited by (0)

: Grant Support: This study was funded by St Jude Medical Inc.

: Potential Competing Interests: Mr Brunner and Dr Mahapatra are full time employees of St Jude Medical. Dr Bunch has served as a consultant for Biosense Webster, St Jude Medical, and Boston Scientific; he has performed research sponsored by Gilead Pharmaceuticals, Boston Scientific, Biosense Webster, and St Jude Medical. Mr Mullin is employed by NAMSA, a company that provides consulting services to St Jude Medical. Mr Elliot was an employee of St Jude Medical at the time of this research. Dr May, Ms Bair, and Dr Anderson have no competing interests to disclose.