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New model for atrial fibrillation

Assessing the risk of developing atrial fibrillation, itself a pointer for stroke and heart failure, has been improved by a 10-year trial at Boston University School of Medicine in the USA.

As reported in the Lancet, the resulting risk score has good predictive value and is only slightly improved by standard echocardiographic measures.

Data from the Framingham Heart Study were used to develop a score from clinical characteristics, while Cox regression models were used to assess risk factors. Age, sex, body mass index, systolic blood pressure, treatment for hypertension, PR interval, clinically significant heart murmur, and heart failure were the strongest risk factors associated with atrial fibrillation, and were included in the final model.

The authors conclude: "Our risk-prediction score provides clinicians with an easily-applicable method to improve risk assessment and communication of risk for individuals, and targeting intervention in routine clinical practice."

David Brieger and Ben Freedman from Concord Hospital, University of Sydney, say: "Atrial fibrillation is associated with a doubling of the mortality rate, particularly within the first four months of diagnosis.

"Few would argue against the assertion that an ounce of prevention is worth a pound of cure. This predictive model is the first step in that direction."

They conclude that identification of increased risk that can be easily assessed in primary care settings would make it possible to test new or currently available therapies which might prevent the condition.

Copyright © Press Association 2009

The Lancet