Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.
Am J Cardiol. 2011 Jan;107(1):85-91. doi: 10.1016/j.amjcard.2010.08.049.
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.
一个房颤（AF）的风险评分已由弗雷明汉心脏研究开发；然而，这个风险评分来源于白人患者的数据，其在预测非白人患者新发房颤的适用性是不确定的。因此，我们使用来自美国动脉粥样硬化风险社区（ARIC）研究的 14546 名黑人和白人的临床实践中常用的危险因素，开发了一个用于预测新发房颤的 10 年风险评分。在 10 年的随访期间，发生了 515 例新发房颤事件。房颤风险评分中包括以下变量：年龄、种族、身高、吸烟状况、收缩压、高血压药物使用、心前区杂音、左心室肥厚、左心房扩大、糖尿病、冠心病和心力衰竭。包含上述变量的 Cox 回归模型的接受者操作特征曲线（AUC）下面积为 0.78，表明具有中度良好的区分度。从 Cox 模型系数中开发的基于点的评分的 AUC 为 0.76。该 ARIC 队列中用于房颤的临床风险评分与弗雷明汉心脏研究的房颤（AUC 0.68）、冠心病（CHD）（AUC 0.63）和硬 CHD（AUC 0.59）风险评分以及 ARIC CHD 风险评分（AUC 0.58）相比表现良好。总之，我们已经开发了一种房颤风险评分，并表明房颤和 CHD 的不同病理生理学限制了 CHD 风险评分在识别具有更高房颤风险的患者中的有用性。
