TY - JOUR
T1 - Predicting Silent Atrial Fibrillation in the Elderly
T2 - A Report from the NOMED-AF Cross-Sectional Study
AU - Mitrega, Katarzyna
AU - Lip, Gregory Y H
AU - Sredniawa, Beata
AU - Sokal, Adam
AU - Streb, Witold
AU - Przyludzki, Karol
AU - Zdrojewski, Tomasz
AU - Wierucki, Lukasz
AU - Rutkowski, Marcin
AU - Bandosz, Piotr
AU - Kazmierczak, Jaroslaw
AU - Grodzicki, Tomasz
AU - Opolski, Grzegorz
AU - Kalarus, Zbigniew
PY - 2021/5/26
Y1 - 2021/5/26
N2 - BACKGROUND: Silent atrial fibrillation (SAF) is common and is associated with poor outcomes.AIMS: to study the risk factors for AF and SAF in the elderly (≥65 years) general population and to develop a risk stratification model for predicting SAF.METHODS: Continuous ECG monitoring was performed for up to 30 days using a vest-based system in a cohort from NOMED-AF, a cross-sectional study based on a nationwide population sample. The independent risk factors for AF and SAF were determined using multiple logistic regression. ROC analysis was applied to validate the developed risk stratification score.RESULTS: From the total cohort of 3014 subjects, AF was diagnosed in 680 individuals (mean age, 77.5 ± 7.9; 50.1% men) with AF, and, of these, 41% had SAF. Independent associations with an increased risk of AF were age, male gender, coronary heart disease, thyroid diseases, prior ischemic stroke or transient ischemic attack (ICS/TIA), diabetes, heart failure, chronic kidney disease (CKD), obesity, and NT-proBNP >125 ng/mL. The risk factors for SAF were age, male gender, ICS/TIA, diabetes, heart failure, CKD, and NT-proBNP >125 ng/mL. We developed a clinical risk scale (MR-DASH score) that achieved a good level of prediction in the derivation cohort (AUC 0.726) and the validation cohort (AUC 0.730).CONCLUSIONS: SAF is associated with various clinical risk factors in a population sample of individuals ≥65 years. Stratifying individuals from the general population according to their risk for SAF may be possible using the MR-DASH score, facilitating targeted screening programs of individuals with a high risk of SAF.
AB - BACKGROUND: Silent atrial fibrillation (SAF) is common and is associated with poor outcomes.AIMS: to study the risk factors for AF and SAF in the elderly (≥65 years) general population and to develop a risk stratification model for predicting SAF.METHODS: Continuous ECG monitoring was performed for up to 30 days using a vest-based system in a cohort from NOMED-AF, a cross-sectional study based on a nationwide population sample. The independent risk factors for AF and SAF were determined using multiple logistic regression. ROC analysis was applied to validate the developed risk stratification score.RESULTS: From the total cohort of 3014 subjects, AF was diagnosed in 680 individuals (mean age, 77.5 ± 7.9; 50.1% men) with AF, and, of these, 41% had SAF. Independent associations with an increased risk of AF were age, male gender, coronary heart disease, thyroid diseases, prior ischemic stroke or transient ischemic attack (ICS/TIA), diabetes, heart failure, chronic kidney disease (CKD), obesity, and NT-proBNP >125 ng/mL. The risk factors for SAF were age, male gender, ICS/TIA, diabetes, heart failure, CKD, and NT-proBNP >125 ng/mL. We developed a clinical risk scale (MR-DASH score) that achieved a good level of prediction in the derivation cohort (AUC 0.726) and the validation cohort (AUC 0.730).CONCLUSIONS: SAF is associated with various clinical risk factors in a population sample of individuals ≥65 years. Stratifying individuals from the general population according to their risk for SAF may be possible using the MR-DASH score, facilitating targeted screening programs of individuals with a high risk of SAF.
KW - Risk assessment
KW - Risk factors
KW - Silent atrial fibrillation
UR - http://www.scopus.com/inward/record.url?scp=85112324342&partnerID=8YFLogxK
U2 - 10.3390/jcm10112321
DO - 10.3390/jcm10112321
M3 - Journal article
C2 - 34073411
SN - 2077-0383
VL - 10
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 11
M1 - 2321
ER -