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Risk assessment for incident heart failure in individuals with atrial fibrillation.

Publication ,  Journal Article
Schnabel, RB; Rienstra, M; Sullivan, LM; Sun, JX; Moser, CB; Levy, D; Pencina, MJ; Fontes, JD; Magnani, JW; McManus, DD; Lubitz, SA; Wang, TJ ...
Published in: Eur J Heart Fail
August 2013

BACKGROUND: Atrial fibrillation (AF) is a strong risk factor for heart failure (HF); HF onset in patients with AF is associated with increased morbidity and mortality. Risk factors that predict HF in individuals with AF in the community are not well established. METHODS AND RESULTS: We examined clinical variables related to the 10-year incidence of HF in 725 individuals (mean 73.3 years, 45% women) with documented AF in the Framingham Heart Study. Event rates for incident HF (n = 161, 48% in women) were comparable in women (4.30 per 100 person-years) and men (3.34 per 100 person-years). Age, body mass index, ECG LV hypertrophy, diabetes, significant murmur, and history of myocardial infarction were positively associated with incident HF in multivariable models (C-statistic 0.71; 95% confidence interval 0.67-0.75). We developed a risk algorithm for estimating absolute risk of HF in AF patients with good model fit and calibration (adjusted calibration χ2 statistic 7.29; P(χ2) = 0.61). Applying the algorithm, 47.6% of HF events occurred in the top tertile in men compared with 13.1% in the bottom tertile, and 58.4% in women in the upper tertile compared with 18.2% in the lowest category. For HF type, women had a non-significantly higher incidence of HF with preserved EF compared with men. CONCLUSIONS: We describe advancing age, LV hypertrophy, body mass index, diabetes, significant heart murmur, and history of myocardial infarction as clinical predictors of incident HF in individuals with AF. A risk algorithm may help identify individuals with AF at high risk of developing HF.

Duke Scholars

Published In

Eur J Heart Fail

DOI

EISSN

1879-0844

Publication Date

August 2013

Volume

15

Issue

8

Start / End Page

843 / 849

Location

England

Related Subject Headings

  • Risk Factors
  • Risk Assessment
  • Proportional Hazards Models
  • Overweight
  • Myocardial Infarction
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Incidence
  • Hypertrophy, Left Ventricular
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Schnabel, R. B., Rienstra, M., Sullivan, L. M., Sun, J. X., Moser, C. B., Levy, D., … Benjamin, E. J. (2013). Risk assessment for incident heart failure in individuals with atrial fibrillation. Eur J Heart Fail, 15(8), 843–849. https://doi.org/10.1093/eurjhf/hft041
Schnabel, Renate B., Michiel Rienstra, Lisa M. Sullivan, Jenny X. Sun, Carlee B. Moser, Daniel Levy, Michael J. Pencina, et al. “Risk assessment for incident heart failure in individuals with atrial fibrillation.Eur J Heart Fail 15, no. 8 (August 2013): 843–49. https://doi.org/10.1093/eurjhf/hft041.
Schnabel RB, Rienstra M, Sullivan LM, Sun JX, Moser CB, Levy D, et al. Risk assessment for incident heart failure in individuals with atrial fibrillation. Eur J Heart Fail. 2013 Aug;15(8):843–9.
Schnabel, Renate B., et al. “Risk assessment for incident heart failure in individuals with atrial fibrillation.Eur J Heart Fail, vol. 15, no. 8, Aug. 2013, pp. 843–49. Pubmed, doi:10.1093/eurjhf/hft041.
Schnabel RB, Rienstra M, Sullivan LM, Sun JX, Moser CB, Levy D, Pencina MJ, Fontes JD, Magnani JW, McManus DD, Lubitz SA, Tadros TM, Wang TJ, Ellinor PT, Vasan RS, Benjamin EJ. Risk assessment for incident heart failure in individuals with atrial fibrillation. Eur J Heart Fail. 2013 Aug;15(8):843–849.
Journal cover image

Published In

Eur J Heart Fail

DOI

EISSN

1879-0844

Publication Date

August 2013

Volume

15

Issue

8

Start / End Page

843 / 849

Location

England

Related Subject Headings

  • Risk Factors
  • Risk Assessment
  • Proportional Hazards Models
  • Overweight
  • Myocardial Infarction
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Incidence
  • Hypertrophy, Left Ventricular