Simple Risk Model Predicts Incidence of Atrial Fibrillation in a Racially and Geographically Diverse Population: the CHARGE-AF Consortium

被引：692

作者：

Alonso, Alvaro ^{[1
]}

Krijthe, Bouwe P. ^{[2
]}

Aspelund, Thor ^{[5
,6
]}

Stepas, Katherine A. ^{[7
]}

Pencina, Michael J. ^{[7
]}

Moser, Carlee B. ^{[7
]}

Sinner, Moritz F. ^{[14
,15
,18
,26
]}

Sotoodehnia, Nona ^{[10
,11
]}

Fontes, Joao D. ^{[14
,15
]}

Janssens, A. Cecile J. W. ^{[2
]}

Kronmal, Richard A. ^{[12
]}

Magnani, Jared W. ^{[14
,15
,16
]}

Witteman, Jacqueline C. ^{[2
]}

Chamberlain, Alanna M. ^{[17
]}

Lubitz, Steven A. ^{[9
,18
]}

Schnabel, Renate B. ^{[19
]}

Agarwal, Sunil K. ^{[20
]}

McManus, David D. ^{[14
,15
,30
,31
,32
]}

Ellinor, Patrick T. ^{[9
,18
]}

Larson, Martin G. ^{[14
,15
]}

Burke, Gregory L. ^{[22
]}

Launer, Lenore J. ^{[23
]}

Hofman, Albert ^{[2
]}

Levy, Daniel ^{[14
,15
,24
]}

Gottdiener, John S. ^{[25
]}

Kaeaeb, Stefan ^{[26
,29
]}

Couper, David ^{[21
]}

Harris, Tamara B. ^{[23
]}

Soliman, Elsayed Z. ^{[27
]}

Stricker, Bruno H. C. ^{[2
,3
,4
,28
]}

Gudnason, Vilmundur ^{[5
,6
]}

Heckbert, Susan R. ^{[13
]}

Benjamin, Emelia J. ^{[8
,14
,15
,16
]}

机构：

[1] Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, Minneapolis, MN 55454 USA

[2] Erasmus MC, Dept Epidemiol, Rotterdam, Netherlands

[3] Erasmus MC, Dept Internal Med, Rotterdam, Netherlands

[4] Erasmus MC, Dept Med Informat, Rotterdam, Netherlands

[5] Iceland Heart Assoc, Res Inst, Kopavogur, Iceland

[6] Univ Iceland, Reykjavik, Iceland

[7] Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA USA

[8] Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA USA

[9] Massachusetts Gen Hosp, Cardiac Arrhythmia Serv, Boston, MA 02114 USA

[10] Univ Washington, Dept Med, Div Cardiol, Seattle, WA USA

[11] Univ Washington, Dept Med, Cardiovasc Hlth Res Unit, Seattle, WA USA

[12] Univ Washington, Dept Biostat, Seattle, WA 98195 USA

[13] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA

[14] NHLBI, Framingham, MA USA

[15] Boston Univ, Framingham Heart Study, Framingham, MA USA

[16] Boston Univ, Sch Med, Dept Med, Boston, MA 02118 USA

[17] Mayo Clin, Dept Hlth Sci Res, Rochester, MN USA

[18] Massachusetts Gen Hosp, Cardiovasc Res Ctr, Charlestown, MA USA

[19] Univ Heart Ctr Hamburg Eppendorf, Dept Gen & Intervent Cardiol, Eppendorf, Germany

[20] Univ N Carolina, Gillings Sch Global Publ Hlth, Dept Epidemiol, Chapel Hill, NC USA

[21] Univ N Carolina, Gillings Sch Global Publ Hlth, Dept Biostat, Chapel Hill, NC USA

[22] Wake Forest Sch Med, Div Publ Hlth Sci, Winston Salem, NC USA

[23] NIA, Lab Epidemiol Demog & Biometry, NIH, Bethesda, MD 20892 USA

[24] NHLBI, Ctr Populat Studies, Bethesda, MD 20892 USA

[25] Univ Maryland, Med Ctr, Div Cardiol, Baltimore, MD 21201 USA

[26] Univ Munich, Univ Hosp Munich, Dept Med 1, Munich, Germany

[27] Wake Forest Univ, Sch Med, Dept Epidemiol & Prevent, Epidemiol Cardiol Res Ctr EPICARE, Winston Salem, NC 27109 USA

[28] Inspectorate Hlth Care, The Hague, Netherlands

[29] Munich Heart Alliance, Munich, Germany

[30] Univ Massachusetts, Dept Med, Worcester, MA 01605 USA

[31] Univ Massachusetts, Dept Quantitat Hlth Sci, Worcester, MA 01605 USA

[32] Worcester Polytech Inst, Dept Biomed Engn, Worcester, MA 01609 USA

来源：

JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2013年 / 2卷 / 02期

关键词：

atrial fibrillation; epidemiology; risk factors; ATHEROSCLEROSIS RISK; SURVIVAL ANALYSIS; HEART; STROKE; PREVALENCE; DESIGN; WHITES; SCORE; ELECTROCARDIOGRAM; DISCRIMINATION;

D O I：

10.1161/JAHA.112.000102

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Background-Tools for the prediction of atrial fibrillation (AF) may identify high-risk individuals more likely to benefit from preventive interventions and serve as a benchmark to test novel putative risk factors. Methods and Results-Individual-level data from 3 large cohorts in the United States (Atherosclerosis Risk in Communities [ARIC] study, the Cardiovascular Health Study [CHS], and the Framingham Heart Study [FHS]), including 18 556 men and women aged 46 to 94 years (19% African Americans, 81% whites) were pooled to derive predictive models for AF using clinical variables. Validation of the derived models was performed in 7672 participants from the Age, Gene and Environment-Reykjavik study (AGES) and the Rotterdam Study (RS). The analysis included 1186 incident AF cases in the derivation cohorts and 585 in the validation cohorts. A simple 5-year predictive model including the variables age, race, height, weight, systolic and diastolic blood pressure, current smoking, use of antihypertensive medication, diabetes, and history of myocardial infarction and heart failure had good discrimination (C-statistic, 0.765; 95% CI, 0.748 to 0.781). Addition of variables from the electrocardiogram did not improve the overall model discrimination (C-statistic, 0.767; 95% CI, 0.750 to 0.783; categorical net reclassification improvement, -0.0032; 95% CI, -0.0178 to 0.0113). In the validation cohorts, discrimination was acceptable (AGES C-statistic, 0.664; 95% CI, 0.632 to 0.697 and RS C-statistic, 0.705; 95% CI, 0.664 to 0.747) and calibration was adequate. Conclusion-A risk model including variables readily available in primary care settings adequately predicted AF in diverse populations from the United States and Europe.

引用

页数：20

共 40 条

[1]

Prediction of Incident Heart Failure in General Practice The Atherosclerosis Risk in Communities (ARIC) Study [J].