Predicting Atrial Fibrillation and Its Complications

Overview

Journal Circ J

Specialty Cardiology & Vascular Diseases

Date 2016 Mar 25

PMID 27008924

Citations 17

Authors

Alvaro Alonso

Faye L Norby

Affiliations

Soon will be listed here.

Abstract

Atrial fibrillation (AF) is a common cardiac arrhythmia associated with an increased risk of stroke and other complications. Identifying individuals at higher risk of developing AF in the community is now possible using validated predictive models that take into account clinical variables and circulating biomarkers. These models have shown adequate performance in racially and ethnically diverse populations. Similarly, risk stratification schemes predict incidence of ischemic stroke in persons with AF, assisting clinicians and patients in decisions regarding oral anticoagulation use. Complementary schemes have been developed to predict the risk of bleeding in AF patients taking vitamin K antagonists. However, major gaps exist in our ability to predict AF and its complications. Additional research should refine models for AF prediction and determine their value to improve population health and clinical outcomes, advance our ability to predict stroke and other complications in AF patients, and develop predictive models for bleeding events and other adverse effects in patients using non-vitamin K oral anticoagulants. (Circ J 2016; 80: 1061-1066).

Citing Articles

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References

Gage B, Waterman A, Shannon W, Boechler M, Rich M, Radford M . Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001; 285(22):2864-70. DOI: 10.1001/jama.285.22.2864. View

Wang T, Massaro J, Levy D, Vasan R, Wolf P, DAgostino R . A risk score for predicting stroke or death in individuals with new-onset atrial fibrillation in the community: the Framingham Heart Study. JAMA. 2003; 290(8):1049-56. DOI: 10.1001/jama.290.8.1049. View

Gage B, Yan Y, E Milligan P, Waterman A, Culverhouse R, Rich M . Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J. 2006; 151(3):713-9. DOI: 10.1016/j.ahj.2005.04.017. View

Schnabel R, Sullivan L, Levy D, Pencina M, Massaro J, DAgostino Sr R . Development of a risk score for atrial fibrillation (Framingham Heart Study): a community-based cohort study. Lancet. 2009; 373(9665):739-45. PMC: 2764235. DOI: 10.1016/S0140-6736(09)60443-8. View

Alonso A, Agarwal S, Soliman E, Ambrose M, Chamberlain A, Prineas R . Incidence of atrial fibrillation in whites and African-Americans: the Atherosclerosis Risk in Communities (ARIC) study. Am Heart J. 2009; 158(1):111-7. PMC: 2720573. DOI: 10.1016/j.ahj.2009.05.010. View

Lip G, Nieuwlaat R, Pisters R, Lane D, Crijns H . Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest. 2009; 137(2):263-72. DOI: 10.1378/chest.09-1584. View

Steyerberg E, Vickers A, Cook N, Gerds T, Gonen M, Obuchowski N . Assessing the performance of prediction models: a framework for traditional and novel measures. Epidemiology. 2009; 21(1):128-38. PMC: 3575184. DOI: 10.1097/EDE.0b013e3181c30fb2. View

Schnabel R, Larson M, Yamamoto J, Sullivan L, Pencina M, Meigs J . Relations of biomarkers of distinct pathophysiological pathways and atrial fibrillation incidence in the community. Circulation. 2010; 121(2):200-7. PMC: 3224826. DOI: 10.1161/CIRCULATIONAHA.109.882241. View

Pisters R, Lane D, Nieuwlaat R, de Vos C, Crijns H, Lip G . A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010; 138(5):1093-100. DOI: 10.1378/chest.10-0134. View

10.

Camm A, Kirchhof P, Lip G, Schotten U, Savelieva I, Ernst S . Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010; 31(19):2369-429. DOI: 10.1093/eurheartj/ehq278. View

11.

Smith J, Newton-Cheh C, Almgren P, Struck J, Morgenthaler N, Bergmann A . Assessment of conventional cardiovascular risk factors and multiple biomarkers for the prediction of incident heart failure and atrial fibrillation. J Am Coll Cardiol. 2010; 56(21):1712-9. PMC: 3005324. DOI: 10.1016/j.jacc.2010.05.049. View

12.

Schnabel R, Aspelund T, Li G, Sullivan L, Suchy-Dicey A, Harris T . Validation of an atrial fibrillation risk algorithm in whites and African Americans. Arch Intern Med. 2010; 170(21):1909-17. PMC: 3021784. DOI: 10.1001/archinternmed.2010.434. View

13.

Chamberlain A, Agarwal S, Folsom A, Soliman E, Chambless L, Crow R . A clinical risk score for atrial fibrillation in a biracial prospective cohort (from the Atherosclerosis Risk in Communities [ARIC] study). Am J Cardiol. 2010; 107(1):85-91. PMC: 3031130. DOI: 10.1016/j.amjcard.2010.08.049. View

14.

Fang M, Go A, Chang Y, Borowsky L, Pomernacki N, Udaltsova N . A new risk scheme to predict warfarin-associated hemorrhage: The ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) Study. J Am Coll Cardiol. 2011; 58(4):395-401. PMC: 3175766. DOI: 10.1016/j.jacc.2011.03.031. View

15.

Cameli M, Lisi M, Focardi M, Reccia R, Natali B, Sparla S . Left atrial deformation analysis by speckle tracking echocardiography for prediction of cardiovascular outcomes. Am J Cardiol. 2012; 110(2):264-9. DOI: 10.1016/j.amjcard.2012.03.022. View

16.

Ellinor P, Lunetta K, Albert C, Glazer N, Ritchie M, Smith A . Meta-analysis identifies six new susceptibility loci for atrial fibrillation. Nat Genet. 2012; 44(6):670-5. PMC: 3366038. DOI: 10.1038/ng.2261. View

17.

Nakanishi K, Fukuda S, Tanaka A, Otsuka K, Sakamoto M, Taguchi H . Peri-atrial epicardial adipose tissue is associated with new-onset nonvalvular atrial fibrillation. Circ J. 2012; 76(12):2748-54. DOI: 10.1253/circj.cj-12-0637. View

18.

Piccini J, Stevens S, Chang Y, Singer D, Lokhnygina Y, Go A . Renal dysfunction as a predictor of stroke and systemic embolism in patients with nonvalvular atrial fibrillation: validation of the R(2)CHADS(2) index in the ROCKET AF (Rivaroxaban Once-daily, oral, direct factor Xa inhibition Compared with vitamin.... Circulation. 2012; 127(2):224-32. DOI: 10.1161/CIRCULATIONAHA.112.107128. View

19.

Zuo M, Liu S, Chan K, Lau K, Chong B, Lam K . The CHADS2 and CHA 2DS 2-VASc scores predict new occurrence of atrial fibrillation and ischemic stroke. J Interv Card Electrophysiol. 2013; 37(1):47-54. DOI: 10.1007/s10840-012-9776-0. View

20.

Everett B, Cook N, Conen D, Chasman D, Ridker P, Albert C . Novel genetic markers improve measures of atrial fibrillation risk prediction. Eur Heart J. 2013; 34(29):2243-51. PMC: 3730133. DOI: 10.1093/eurheartj/eht033. View