The mC2HEST Score for Incident Atrial Fibrillation
Background: Assessing individuals’ risk of developing incident atrial fibrillation (AF) is important for making preventive and screening strategies. Objectives: The performance of the mC2HEST score for predicting incident AF has scarcely been evaluated, especially in a multi-ethnic population. Metho...
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| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-02-01
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| Series: | JACC: Advances |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772963X24008019 |
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| Summary: | Background: Assessing individuals’ risk of developing incident atrial fibrillation (AF) is important for making preventive and screening strategies. Objectives: The performance of the mC2HEST score for predicting incident AF has scarcely been evaluated, especially in a multi-ethnic population. Methods: Participants from the MESA (Multi-Ethnic Study of Atherosclerosis were enrolled in the present study, which involved population of different ethnicities (Caucasian, African-American, Chinese-American, and Hispanic) aged between 45 and 84 from 6 communities in the United States. The discriminative and calibration performance of the mC2HEST score was compared with other risk models. Results: A total of 4,524 subjects (mean age 60.2 ± 9.5 years; 53.0% female) were included; 565 (mean age 67.0 ± 7.9 years; 46.5% female) developed AF during 13.6 ± 2.5 years of follow-up, with an incidence of 0.93%/year. The mC2HEST score had good prediction at 10 years (C-index, 0.72; 95% CI: 0.701 to 0.753), and 15 years (0.773, 95% CI: 0.749 to 0.798). The risk of incident AF increased with higher mC2HEST score points and risk groups (log-rank P < 0.001). The mC2HEST score showed positive net reclassification indexes (0.057, 0.090, 0.128, and 0.143) and integrated discriminative improvement (3.2%, 3.9%, 5.7%, and 4.9%) compared with C2HEST, HAVOC, HATCH, and CHA2DS2-VASc scores, respectively. Optimal calibration was seen in the mC2HEST score (P = 0.41). Conclusions: The mC2HEST score is a practical model for predicting individuals’ risk of incident AF that may be used for guiding AF surveillance, resource allocation, and screening strategies. |
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| ISSN: | 2772-963X |