Novel risk score predicts AF in high-risk patients

Mitchell S.V. Elkind

Patients at high risk for atrial fibrillation were identified using a novel risk score, according to an abstract presented at the International Stroke Conference.

“Physicians should be aware that atrial fibrillation, a heart rhythm disorder that can lead to stroke, can be found in almost a third of high-risk patients,” Mitchell S.V. Elkind, MD, MS, professor of neurology and epidemiology at Columbia University’s Vagelos College of Physicians and Surgeons, told Cardiology Today. “Those at high risk includes particularly those over 75 who are obese and especially those who also have hypertension, valvular disease, obesity, vascular disease, coronary disease or congestive HF.”

Researchers analyzed data from 391 participants from the REVEAL-AF study who were at risk for AF and were not taking antiarrhythmic drugs. Participants who had an ischemic stroke less than a year before enrollment were excluded.

HAVOC risk scores were calculated, which took into consideration whether a participant was aged at least 75 years and had hypertension, valvular disease, obesity, vascular disease, CAD and congestive HF. Participants were then classified by whether they had a low score (0-4; 24%), an intermediate score (5-9; 62%) or a high score (10-14; 14%).

At 18 months, participants with low scores had a lower incidence of AF (19.5%) compared with those with intermediate (32.1%) or high scores (34.2%; P = .045).

Participants with (27.1%) and without (29.9%) a history of remote stroke had a similar incidence of AF (P > .05).

“It is important to understand whether those who have AF detected using extended monitoring are at increased risk of stroke, and whether use of blood thinners can prevent strokes in these patients,” Elkind told Cardiology Today. – by Darlene Dobkowski

Reference:

Elkind MSV, et al. Abstract 189. Presented at: International Stroke Conference; Jan. 23-26, 2018; Los Angeles.

Disclosures: Elkind reports he is an expert witness for Auxilium, Hi-Tech Pharmaceutical and Merck/Organon; a consultant or on the advisory board for Abbott, Biotelemetry/Cardionet, Boehringer Ingelheim, Medtronic and Sanofi/Regeneron; and receives other support from UpToDate.