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A Clinical Risk Score for Atrial Fibrillation in a Biracial Prospective Cohort (from the Atherosclerosis Risk In Communities [ARIC] Study)
Open accessAbstract
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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“Although men have higher absolute rates for incidence of AF, the relative rates of incident AF associated with diabetes are higher in women than in men for both T1DM and T2DM.[586][587][588]”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [586]
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“Recent, large analyses confirmed that T1DM was also independently associated with a higher incidence of AF. [586][587][588]”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [586]
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“Obesity [6, 7] was identified as a contributing factor but not a diagnosis of alcohol dependence; however, other lifestyle and behavioral variables including the level of alcohol consumption, smoking, physical inactivity, and family history of AF were absent from our dataset.”
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Metadata
- Authors
- Chamberlain, A. M., Agarwal, S. K., Folsom, A. R., Soliman, E. Z., Chambless, L. E., Crow, R., Ambrose, M., & Alonso, A.
- Affiliations
- Mayo Clinic (US)
- University of North Carolina at Chapel Hill (US)
- University of Minnesota (US)
- Wake Forest University Health Sciences (US)
- Johns Hopkins University (US)
- Corresponding author
- Chamberlain, Alanna M.
- ORCID
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 107
- Issue
- 1
- Pages
- 85-91
- ISSN
- 0002-9149 (ISSN-L)
- PMC
- PMC3031130
- OpenAlex
- W2154432863
- Cited by
- 354
- References
- 30
- Citations by year
- 2026: 6 · 2025: 22 · 2024: 25 · 2023: 19 · 2022: 24 · 2021: 37 · 2020: 30 · 2019: 14 · 2018: 24 · 2017: 26 · 2016: 33 · 2015: 17 · 2014: 22 · 2013: 31 · 2012: 14
- FWCI
- 11.85
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- American Heart Association (RC1HL101056, RC1HL099452)
- National Heart, Lung, and Blood Institute (T32-HL-007779, 09SDG2280087)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- atrial fibrillation, risk score, new-onset atrial fibrillation, Framingham Heart Study, Atherosclerosis Risk in Communities Study, racial differences, black and white populations, left atrial enlargement, left ventricular hypertrophy, hypertension, diabetes mellitus, heart failure, coronary artery disease
- MeSH terms
- Atrial Fibrillation, Female, Follow-Up Studies, Forecasting, Humans, Male, Middle Aged, Risk Factors, Cohort Studies, Incidence
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