Universität zu Köln

Pfister, Roman, Braegelmann, Johannes, Michels, Guido, Wareham, Nick J., Luben, Robert and Khaw, Kay-Tee (2015). Performance of the CHARGE-AF risk model for incident atrial fibrillation in the EPIC Norfolk cohort. Eur. J. Prev. Cardiol., 22 (7). S. 932 - 940. LONDON: SAGE PUBLICATIONS LTD. ISSN 2047-4881

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Abstract

Background Identification of individuals at risk for developing atrial fibrillation (AF) will help to target screening and preventive interventions. We aimed to validate the CHARGE-AF model (including variables age, race, height, weight, blood pressure, smoking, antihypertensive medication, diabetes, myocardial infarction and heart failure) for prediction of five-year incident AF in a representative European population with a wide age range. Methods and results The CHARGE-AF model was calculated in 24,020 participants of the population-based EPIC Norfolk study with 236 cases of hospitalization with diagnosis of AF within five years. The model showed good discrimination (c-statistic 0.81, 95% confidence interval (CI) 0.75-0.85), but weak calibration (Chi(2)-statistic 142) with an almost two-fold overestimation of AF incidence. A recalibration to characteristics of the European Prospective Investigation into Cancer and Nutrition (EPIC) Norfolk cohort improved calibration considerably (Chi(2)-statistic 13.3), with acceptable discrimination in participants both >65 and 65 years of age (c-statistics 0.70, 95% CI 0.61-0.77 and 0.83, 95% CI 0.74-0.88). The recalibrated model also showed good discrimination in participants free of cardiovascular disease (c-statistics 0.80, 95% CI 0.75-0.84). Categories of predicted risk (<2.5%, 2.5-5% or >5%) showed good concordance with observed five-year AF incidence of 0.62%, 3.49% and 8.74% (log rank test p<0.001), respectively. Conclusion A recalibration of the CHARGE-AF model is necessary for accurate predictions of five-year risk of AF in the EPIC Norfolk population. The recalibrated model showed good discrimination across a wide age range and in individuals free of cardiovascular disease, and hence is broadly applicable in primary care to identify people at risk for development of AF.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Braegelmann, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Michels, Guido UNSPECIFIED UNSPECIFIED UNSPECIFIED Wareham, Nick J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Luben, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Khaw, Kay-Tee UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-400286
DOI:	10.1177/2047487314544045
Journal or Publication Title:	Eur. J. Prev. Cardiol.
Volume:	22
Number:	7
Page Range:	S. 932 - 940
Date:	2015
Publisher:	SAGE PUBLICATIONS LTD
Place of Publication:	LONDON
ISSN:	2047-4881
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CORONARY-HEART-DISEASE; ATHEROSCLEROSIS RISK; SURVIVAL ANALYSIS; GENERAL-PRACTICE; TASK-FORCE; POPULATION; SCORE; FAILURE; TRENDS; DISCRIMINATION Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40028