Clinical Risk Score for the Prediction of Incident Atrial Fibrillation: Derivation in 7 220 654 Taiwan Patients With 438 930 Incident Atrial Fibrillations During a 16‐Year Follow‐Up
Background Although several risk schemes have been proposed to predict new‐onset atrial fibrillation (AF), clinical prediction models specific for Asian patients were limited. In the present study, we aimed to develop a clinical risk score (Taiwan AF score) for AF prediction using the whole Taiwan p...
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doaj-f11a7a0871264234b2d4ba8eb94a61062021-09-07T18:11:46ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-09-01101710.1161/JAHA.120.020194Clinical Risk Score for the Prediction of Incident Atrial Fibrillation: Derivation in 7 220 654 Taiwan Patients With 438 930 Incident Atrial Fibrillations During a 16‐Year Follow‐UpTze‐Fan Chao0Chern‐En Chiang1Tzeng‐Ji Chen2Jo‐Nan Liao3Ta‐Chuan Tuan4Shih‐Ann Chen5Division of Cardiology Department of Medicine Taipei Veterans General Hospital Taipei TaiwanDivision of Cardiology Department of Medicine Taipei Veterans General Hospital Taipei TaiwanDepartment of Family Medicine Taipei Veterans General Hospital Taipei TaiwanDivision of Cardiology Department of Medicine Taipei Veterans General Hospital Taipei TaiwanDivision of Cardiology Department of Medicine Taipei Veterans General Hospital Taipei TaiwanDivision of Cardiology Department of Medicine Taipei Veterans General Hospital Taipei TaiwanBackground Although several risk schemes have been proposed to predict new‐onset atrial fibrillation (AF), clinical prediction models specific for Asian patients were limited. In the present study, we aimed to develop a clinical risk score (Taiwan AF score) for AF prediction using the whole Taiwan population database with a long‐term follow‐up. Methods and Results Among 7 220 654 individuals aged ≥40 years without a past history of cardiac arrhythmia identified from the Taiwan Health Insurance Research Database, 438 930 incident AFs occurred after a 16‐year follow‐up. Clinical risk factors of AF were identified using Cox regression analysis and then combined into a clinical risk score (Taiwan AF score). The Taiwan AF score included age, male sex, and important comorbidities (hypertension, heart failure, coronary artery disease, end‐stage renal disease, and alcoholism) and ranged from −2 to 15. The area under the receiver operating characteristic curve of the Taiwan AF scores in the predictions of AF are 0.857 for the 1‐year follow‐up, 0.825 for the 5‐year follow‐up, 0.797 for the 10‐year follow‐up, and 0.756 for the 16‐year follow‐up. The annual risks of incident AF were 0.21%/year, 1.31%/year, and 3.37%/year for the low‐risk (score −2 to 3), intermediate‐risk (score 4 to 9), and high‐risk (score ≥10) groups, respectively. Compared with low‐risk patients, the hazard ratios of incident AF were 5.78 (95% CI, 3.76–7.75) for the intermediate‐risk group and 8.94 (95% CI, 6.47–10.80) for the high‐risk group. Conclusions We developed a clinical AF prediction model, the Taiwan AF score, among a large‐scale Asian cohort. The new score could help physicians to identify Asian patients at high risk of AF in whom more aggressive and frequent detections and screenings may be considered.https://www.ahajournals.org/doi/10.1161/JAHA.120.020194atrial fibrillationincidenceTaiwan AF score |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tze‐Fan Chao Chern‐En Chiang Tzeng‐Ji Chen Jo‐Nan Liao Ta‐Chuan Tuan Shih‐Ann Chen |
spellingShingle |
Tze‐Fan Chao Chern‐En Chiang Tzeng‐Ji Chen Jo‐Nan Liao Ta‐Chuan Tuan Shih‐Ann Chen Clinical Risk Score for the Prediction of Incident Atrial Fibrillation: Derivation in 7 220 654 Taiwan Patients With 438 930 Incident Atrial Fibrillations During a 16‐Year Follow‐Up Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atrial fibrillation incidence Taiwan AF score |
author_facet |
Tze‐Fan Chao Chern‐En Chiang Tzeng‐Ji Chen Jo‐Nan Liao Ta‐Chuan Tuan Shih‐Ann Chen |
author_sort |
Tze‐Fan Chao |
title |
Clinical Risk Score for the Prediction of Incident Atrial Fibrillation: Derivation in 7 220 654 Taiwan Patients With 438 930 Incident Atrial Fibrillations During a 16‐Year Follow‐Up |
title_short |
Clinical Risk Score for the Prediction of Incident Atrial Fibrillation: Derivation in 7 220 654 Taiwan Patients With 438 930 Incident Atrial Fibrillations During a 16‐Year Follow‐Up |
title_full |
Clinical Risk Score for the Prediction of Incident Atrial Fibrillation: Derivation in 7 220 654 Taiwan Patients With 438 930 Incident Atrial Fibrillations During a 16‐Year Follow‐Up |
title_fullStr |
Clinical Risk Score for the Prediction of Incident Atrial Fibrillation: Derivation in 7 220 654 Taiwan Patients With 438 930 Incident Atrial Fibrillations During a 16‐Year Follow‐Up |
title_full_unstemmed |
Clinical Risk Score for the Prediction of Incident Atrial Fibrillation: Derivation in 7 220 654 Taiwan Patients With 438 930 Incident Atrial Fibrillations During a 16‐Year Follow‐Up |
title_sort |
clinical risk score for the prediction of incident atrial fibrillation: derivation in 7 220 654 taiwan patients with 438 930 incident atrial fibrillations during a 16‐year follow‐up |
publisher |
Wiley |
series |
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
issn |
2047-9980 |
publishDate |
2021-09-01 |
description |
Background Although several risk schemes have been proposed to predict new‐onset atrial fibrillation (AF), clinical prediction models specific for Asian patients were limited. In the present study, we aimed to develop a clinical risk score (Taiwan AF score) for AF prediction using the whole Taiwan population database with a long‐term follow‐up. Methods and Results Among 7 220 654 individuals aged ≥40 years without a past history of cardiac arrhythmia identified from the Taiwan Health Insurance Research Database, 438 930 incident AFs occurred after a 16‐year follow‐up. Clinical risk factors of AF were identified using Cox regression analysis and then combined into a clinical risk score (Taiwan AF score). The Taiwan AF score included age, male sex, and important comorbidities (hypertension, heart failure, coronary artery disease, end‐stage renal disease, and alcoholism) and ranged from −2 to 15. The area under the receiver operating characteristic curve of the Taiwan AF scores in the predictions of AF are 0.857 for the 1‐year follow‐up, 0.825 for the 5‐year follow‐up, 0.797 for the 10‐year follow‐up, and 0.756 for the 16‐year follow‐up. The annual risks of incident AF were 0.21%/year, 1.31%/year, and 3.37%/year for the low‐risk (score −2 to 3), intermediate‐risk (score 4 to 9), and high‐risk (score ≥10) groups, respectively. Compared with low‐risk patients, the hazard ratios of incident AF were 5.78 (95% CI, 3.76–7.75) for the intermediate‐risk group and 8.94 (95% CI, 6.47–10.80) for the high‐risk group. Conclusions We developed a clinical AF prediction model, the Taiwan AF score, among a large‐scale Asian cohort. The new score could help physicians to identify Asian patients at high risk of AF in whom more aggressive and frequent detections and screenings may be considered. |
topic |
atrial fibrillation incidence Taiwan AF score |
url |
https://www.ahajournals.org/doi/10.1161/JAHA.120.020194 |
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