New Clinical Risk Factor Score for Atrial Fibrillation

A new "score" to assess the clinical risk factors for the development of atrial fibrillation was published in Lancet today based on epidemiologic variables from the Framingham Heart Study and found:

"457 (10%) of the 4764 participants developed atrial fibrillation. Age, sex, body-mass index, systolic blood pressure, treatment for hypertension, PR interval, clinically significant cardiac murmur, and heart failure were associated with atrial fibrillation and incorporated in a risk score (p<0·05, except body-mass index p=0·08), clinical model C statistic 0·78 (95% CI 0·76–0·80). Risk of atrial fibrillation in 10 years varied with age: more than 15% risk was recorded in 53 (1%) participants younger than 65 years, compared with 783 (27%) older than 65 years. Additional incorporation of echocardiographic measurements to enhance the risk prediction model only slightly improved the C statistic from 0·78 (95% CI 0·75–0·80) to 0·79 (0·77–0·82), p=0·005. Echocardiographic measurements did not improve risk reclassification (p=0·18).

Although the "score" they developed seems too cumbersome to be applied easily in the clinical setting, I thought the most interesting findings of their study was what was NOT found to be a clinical predictor of atrial fibrillation risk: alcohol, hypercholesterolemia, smoking or diabetes. (Almost a quarter of their cohort (22%) were classified as "moderate to heavy alcohol consumers" and nearly a third (32%) were smokers).

So when you're at the bar this weekend, relax!

At least statistically you won't be at increased risk of getting atrial fibrillation.

-Wes