Simple risk model predicts incidence of atrial fibrillation in a racially and geographically diverse population: the CHARGE-AF consortium.

Alvaro Alonso, Bouwe P. Krijthe, Thor Aspelund, Katherine A. Stepas, Michael J. Pencina, Carlee B. Moser, Moritz F. Sinner, Nona Sotoodehnia, Joao Daniel T. Fontes, A. Cecile J W Janssens, Richard A. Kronmal, Jared W. Magnani, Jacqueline C. Witteman, Alanna M. Chamberlain, Steven A. Lubitz, Renate B. Schnabel, Sunil K. Agarwal, David D. McManus, Patrick T. Ellinor, Martin G. LarsonGregory L. Burke, Lenore J. Launer, Albert Hofman, Daniel Levy, John S. Gottdiener, Stefan Kääb, David Couper, Tamara B. Harris, Elsayed Z. Soliman, Bruno H C Stricker, Vilmundur Gudnason, Susan R. Heckbert, Emelia J. Benjamin

Research output: Contribution to journalArticle

252 Citations (Scopus)

Abstract

Tools for the prediction of atrial fibrillation (AF) may identify high-risk individuals more likely to benefit from preventive interventions and serve as a benchmark to test novel putative risk factors. Individual-level data from 3 large cohorts in the United States (Atherosclerosis Risk in Communities [ARIC] study, the Cardiovascular Health Study [CHS], and the Framingham Heart Study [FHS]), including 18 556 men and women aged 46 to 94 years (19% African Americans, 81% whites) were pooled to derive predictive models for AF using clinical variables. Validation of the derived models was performed in 7672 participants from the Age, Gene and Environment-Reykjavik study (AGES) and the Rotterdam Study (RS). The analysis included 1186 incident AF cases in the derivation cohorts and 585 in the validation cohorts. A simple 5-year predictive model including the variables age, race, height, weight, systolic and diastolic blood pressure, current smoking, use of antihypertensive medication, diabetes, and history of myocardial infarction and heart failure had good discrimination (C-statistic, 0.765; 95% CI, 0.748 to 0.781). Addition of variables from the electrocardiogram did not improve the overall model discrimination (C-statistic, 0.767; 95% CI, 0.750 to 0.783; categorical net reclassification improvement, -0.0032; 95% CI, -0.0178 to 0.0113). In the validation cohorts, discrimination was acceptable (AGES C-statistic, 0.664; 95% CI, 0.632 to 0.697 and RS C-statistic, 0.705; 95% CI, 0.664 to 0.747) and calibration was adequate. A risk model including variables readily available in primary care settings adequately predicted AF in diverse populations from the United States and Europe.

Original languageEnglish (US)
JournalJournal of the American Heart Association
Volume2
Issue number2
DOIs
StatePublished - Apr 2013
Externally publishedYes

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Atrial Fibrillation
Incidence
Population
Heart Failure
Blood Pressure
Benchmarking
African Americans
Antihypertensive Agents
Calibration
Genes
Primary Health Care
Atherosclerosis
Electrocardiography
Smoking
Myocardial Infarction
Weights and Measures
Health

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Simple risk model predicts incidence of atrial fibrillation in a racially and geographically diverse population : the CHARGE-AF consortium. / Alonso, Alvaro; Krijthe, Bouwe P.; Aspelund, Thor; Stepas, Katherine A.; Pencina, Michael J.; Moser, Carlee B.; Sinner, Moritz F.; Sotoodehnia, Nona; Fontes, Joao Daniel T.; Janssens, A. Cecile J W; Kronmal, Richard A.; Magnani, Jared W.; Witteman, Jacqueline C.; Chamberlain, Alanna M.; Lubitz, Steven A.; Schnabel, Renate B.; Agarwal, Sunil K.; McManus, David D.; Ellinor, Patrick T.; Larson, Martin G.; Burke, Gregory L.; Launer, Lenore J.; Hofman, Albert; Levy, Daniel; Gottdiener, John S.; Kääb, Stefan; Couper, David; Harris, Tamara B.; Soliman, Elsayed Z.; Stricker, Bruno H C; Gudnason, Vilmundur; Heckbert, Susan R.; Benjamin, Emelia J.

In: Journal of the American Heart Association, Vol. 2, No. 2, 04.2013.

Research output: Contribution to journalArticle

Alonso, A, Krijthe, BP, Aspelund, T, Stepas, KA, Pencina, MJ, Moser, CB, Sinner, MF, Sotoodehnia, N, Fontes, JDT, Janssens, ACJW, Kronmal, RA, Magnani, JW, Witteman, JC, Chamberlain, AM, Lubitz, SA, Schnabel, RB, Agarwal, SK, McManus, DD, Ellinor, PT, Larson, MG, Burke, GL, Launer, LJ, Hofman, A, Levy, D, Gottdiener, JS, Kääb, S, Couper, D, Harris, TB, Soliman, EZ, Stricker, BHC, Gudnason, V, Heckbert, SR & Benjamin, EJ 2013, 'Simple risk model predicts incidence of atrial fibrillation in a racially and geographically diverse population: the CHARGE-AF consortium.', Journal of the American Heart Association, vol. 2, no. 2. https://doi.org/10.1161/JAHA.112.000102
Alonso, Alvaro ; Krijthe, Bouwe P. ; Aspelund, Thor ; Stepas, Katherine A. ; Pencina, Michael J. ; Moser, Carlee B. ; Sinner, Moritz F. ; Sotoodehnia, Nona ; Fontes, Joao Daniel T. ; Janssens, A. Cecile J W ; Kronmal, Richard A. ; Magnani, Jared W. ; Witteman, Jacqueline C. ; Chamberlain, Alanna M. ; Lubitz, Steven A. ; Schnabel, Renate B. ; Agarwal, Sunil K. ; McManus, David D. ; Ellinor, Patrick T. ; Larson, Martin G. ; Burke, Gregory L. ; Launer, Lenore J. ; Hofman, Albert ; Levy, Daniel ; Gottdiener, John S. ; Kääb, Stefan ; Couper, David ; Harris, Tamara B. ; Soliman, Elsayed Z. ; Stricker, Bruno H C ; Gudnason, Vilmundur ; Heckbert, Susan R. ; Benjamin, Emelia J. / Simple risk model predicts incidence of atrial fibrillation in a racially and geographically diverse population : the CHARGE-AF consortium. In: Journal of the American Heart Association. 2013 ; Vol. 2, No. 2.
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abstract = "Tools for the prediction of atrial fibrillation (AF) may identify high-risk individuals more likely to benefit from preventive interventions and serve as a benchmark to test novel putative risk factors. Individual-level data from 3 large cohorts in the United States (Atherosclerosis Risk in Communities [ARIC] study, the Cardiovascular Health Study [CHS], and the Framingham Heart Study [FHS]), including 18 556 men and women aged 46 to 94 years (19{\%} African Americans, 81{\%} whites) were pooled to derive predictive models for AF using clinical variables. Validation of the derived models was performed in 7672 participants from the Age, Gene and Environment-Reykjavik study (AGES) and the Rotterdam Study (RS). The analysis included 1186 incident AF cases in the derivation cohorts and 585 in the validation cohorts. A simple 5-year predictive model including the variables age, race, height, weight, systolic and diastolic blood pressure, current smoking, use of antihypertensive medication, diabetes, and history of myocardial infarction and heart failure had good discrimination (C-statistic, 0.765; 95{\%} CI, 0.748 to 0.781). Addition of variables from the electrocardiogram did not improve the overall model discrimination (C-statistic, 0.767; 95{\%} CI, 0.750 to 0.783; categorical net reclassification improvement, -0.0032; 95{\%} CI, -0.0178 to 0.0113). In the validation cohorts, discrimination was acceptable (AGES C-statistic, 0.664; 95{\%} CI, 0.632 to 0.697 and RS C-statistic, 0.705; 95{\%} CI, 0.664 to 0.747) and calibration was adequate. A risk model including variables readily available in primary care settings adequately predicted AF in diverse populations from the United States and Europe.",
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AU - Alonso, Alvaro

AU - Krijthe, Bouwe P.

AU - Aspelund, Thor

AU - Stepas, Katherine A.

AU - Pencina, Michael J.

AU - Moser, Carlee B.

AU - Sinner, Moritz F.

AU - Sotoodehnia, Nona

AU - Fontes, Joao Daniel T.

AU - Janssens, A. Cecile J W

AU - Kronmal, Richard A.

AU - Magnani, Jared W.

AU - Witteman, Jacqueline C.

AU - Chamberlain, Alanna M.

AU - Lubitz, Steven A.

AU - Schnabel, Renate B.

AU - Agarwal, Sunil K.

AU - McManus, David D.

AU - Ellinor, Patrick T.

AU - Larson, Martin G.

AU - Burke, Gregory L.

AU - Launer, Lenore J.

AU - Hofman, Albert

AU - Levy, Daniel

AU - Gottdiener, John S.

AU - Kääb, Stefan

AU - Couper, David

AU - Harris, Tamara B.

AU - Soliman, Elsayed Z.

AU - Stricker, Bruno H C

AU - Gudnason, Vilmundur

AU - Heckbert, Susan R.

AU - Benjamin, Emelia J.

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