Schnabel et al reported a model for predicting the risk of heart failure in a patient with atrial fibrillation. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in the United States and Europe.
Patient selection: atrial fibrillation without heart failure, from 39 to 96 years
Outcome: 10-year risk of congestive heart failure
Parameters:
(1) age in years
(2) body mass index (BMI) in kg per sq m
(3) left ventricular hypertrophy
(4) diabetes
(5) significant murmur (grade >= 3 out of 6 systolic; any diastolic)
(6) history of myocardial infarction
|
Parameter
|
Finding
|
Points
|
|
age in years
|
|
0.063 * (age)
|
|
BMI
|
|
0.062 * (BMI)
|
|
left ventricular hypertrophy
|
no
|
0
|
|
|
yes
|
0.708
|
|
diabetes
|
no
|
0
|
|
|
yes
|
0.632
|
|
significant murmur
|
no
|
0
|
|
|
yes
|
0.607
|
|
history of myocardial infarction
|
no
|
0
|
|
|
yes
|
3.589
|
|
age * history of MI
|
no MI
|
0
|
|
|
MI
|
-0.039 * (age)
|
value of X =
= SUM(points for all of the parameters)
S0: 0.96337
10-year baseline survival: 0.705
Sum of beta-coefficients times mean values: 6.666
probability at 10 years =
= 1 - (0.705^EXP(X - 6.666))
Performance:
• The area under the ROC curve is 0.71.
