Department of Preventive Medicine, National Cerebral and Cardiovascular Center.
Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center.
Circ J. 2017 Oct 25;81(11):1580-1588. doi: 10.1253/circj.CJ-17-0277. Epub 2017 May 25.
An atrial fibrillation (AF) risk score for a non-Western general population has not been established.Methods and Results:A total of 6,898 participants (30-79 years old) initially free of AF have been prospectively followed for incident AF since 1989. AF was diagnosed when AF or atrial flutter was present on ECG at a biannual health examination; was indicated as a current illness; or was in the medical records during follow-up. Cox proportional hazard ratios were analyzed after adjusting for cardiovascular risk factors at baseline. During the 95,180 person-years of follow-up, 311 incident AF events occurred. We developed a scoring system for each risk factor as follows: 0/-5, 3/0, 7/5, and 9/9 points for men/women in their 30 s-40 s, 50 s, 60 s, and 70 s, respectively; 2 points for systolic hypertension, overweight, excessive drinking, or coronary artery disease; 1 point for current smoking; -1 point for moderate non-high-density lipoprotein-cholesterol; 4 points for arrhythmia; and 8, 6, and 2 points for subjects with cardiac murmur in their 30 s-40 s, 50 s, and 60 s, respectively (C-statistic 0.749; 95% confidence interval, 0.724-0.774). Individuals with score ≤2, 10-11, or ≥16 points had, respectively, ≤1%, 9%, and 27% observed probability of developing AF in 10 years.
We developed a 10-year risk score for incident AF using traditional risk factors that are easily obtained in routine outpatient clinics/health examinations without ECG.
尚未建立针对非西方普通人群的心房颤动（AF）风险评分。
共有 6898 名参与者（30-79 岁）自 1989 年以来一直前瞻性随访，以记录是否发生 AF。AF 的诊断依据为心电图上出现 AF 或心房扑动；当前疾病的指示；或随访期间的医疗记录。对基线心血管危险因素进行调整后，分析 Cox 比例风险比。在 95180 人年的随访期间，有 311 例发生了 AF 事件。我们为每个危险因素开发了评分系统：男性/女性 30-40 岁、50 岁、60 岁和 70 岁分别为 0/-5、3/0、7/5 和 9/9 分；收缩压升高、超重、过度饮酒或冠心病为 2 分；当前吸烟为 1 分；中度非高密度脂蛋白胆固醇为-1 分；心律失常为 4 分；30-40 岁、50 岁和 60 岁有心脏杂音的受试者分别为 8、6 和 2 分（C 统计量为 0.749；95%置信区间，0.724-0.774）。评分≤2、10-11 或≥16 的个体在 10 年内分别有≤1%、9%和 27%的观察到的 AF 发生概率。
我们使用在常规门诊/体检中无需心电图即可轻松获得的传统危险因素，开发了一种用于预测 AF 事件的 10 年风险评分。
