Log in to MyACC
New-Onset Atrial Fibrillation Risk Prediction Score
Quick Takes
- The HARMS2-AF score, developed by using UK Biobank and Framingham Heart Study population cohorts, performed comparably with the CHARGE-AF risk score and outperformed the Framingham-AF and ARIC risk scores in predicting incident AF in patients with no prior history of AF.
- The HARMS2-AF score may help in screening the general community for patients at risk for AF.
Study Questions:
Is an atrial fibrillation (AF) lifestyle risk score helpful in identifying individuals at risk of AF in the general population?
Methods:
Clinical information of patients enrolled in the UK (United Kingdom) Biobank (UKB) and Framingham Heart Study (FHS) and who did not have prior AF were analyzed. The authors used regression analysis to identify independent AF predictors. They developed a weighted score in the UKB and validated the findings in the FHS database.
Results:
Among 314,280 UKB participants, AF incidence was 5.7%, with median time to AF of 7.6 years. Hypertension, age, body mass index, male sex, sleep apnea, smoking, and alcohol were predictive of incident AF. Of note, physical inactivity and diabetes were not significant. The HARMS2-AF score had similar predictive performance (area under the curve [AUC], 0.782) to the unweighted model (AUC, 0.802) in the UKB. External validation in the FHS had an AUC of 0.757. A higher HARMS2-AF score (≥5 points) was associated with a heightened AF risk (score 5–9: hazard ratio [HR], 12.79; score 10–14: HR, 38.70). The HARMS2-AF risk model outperformed the Framingham-AF (AUC, 0.568) and ARIC (Atherosclerosis Risk in Communities) (AUC, 0.713) risk models and was comparable to the CHARGE-AF risk score (AUC, 0.754).
Conclusions:
The authors concluded that the HARMS2-AF score may help identify individuals at risk of AF in the general community and assist population screening.
Perspective:
The developed HARMS2-AF score consists of the following: Hypertension (4 points), Age 60-64 years (1 point), Age ≥65 (2 points), Raised body mass index ≥30 kg/m 2 (1 point), Male sex (2 points), Sleep apnea (2 points), Smoking (1 point), Alcohol 7–14 standard drinks/week, (1 point), Alcohol 15 standard drinks/week (2 points). Prior prediction models have incorporated some lifestyle factors but also other factors such as electrocardiography or echocardiography parameters, which may not be routinely accessible. HARMS2-AF is comprised of mostly modifiable risk factors, allowing it not only to identify patients more likely to develop AF, but also provide targets for risk factor modification.
Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, Geriatric Cardiology, Heart Failure and Cardiomyopathies, Prevention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure, Hypertension, Smoking, Sleep Apnea
Keywords: Arrhythmias, Cardiac, Alcohol Drinking, Atrial Fibrillation, Body Mass Index, Geriatrics, Heart Failure, Hypertension, Life Style, Obesity, Risk Factors, Secondary Prevention, Sleep Apnea Syndromes, Smoking
< Back to Listings
