Kwong et al reported a score for identifying a patient at risk for atrial fibrillation. This can be helpful in the evaluation of a patient with cryptogenic stroke or transient ischemic attack. The authors are from Santa Clara Valley Medical Center in San Jose, Stanford University and the University of California at San Francisco.
Parameters:
(1) hypertension (H)
(2) age in years (A)
(3) valve disease (V), aortic, mitral, tricuspid or pulmonary
(4) vascular disease, peripheral (V)
(5) obesity (O)
(6) congestive heart failure (C)
(7) coronary artery disease (C)
Parameter
Finding
Points
hypertension
no
0
yes
2
age in years
< 75 years
0
>= 75 years
2
valve disease
no
0
yes
2
vascular disease
no
0
yes
1
obesity
no
0
yes (BMI > 30 kg per sq m)
1
congestive heart failure
no
0
yes
4
coronary artery disease
no
0
yes
2
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 14
• The higher the score the greater the risk for atrial fibrillation.
Total Score
Percent AF
Risk Group
0 to 4
2 to 3%
low
5 to 9
12%
medium
10 to 14
20-25%
high
Performance:
• The area under the ROC curve is 0.77.
• Ntaios et al found an area of 0.69 and a higher rate of atrial fibrillation in the low risk group.
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