Objective:Individuals'risk of developing incident atrial fibrillation(AF)is increasing.A risk scoring system calculated at baseline may be not suitable for predicting incident AF many years later.We aimed to evaluate the performance of the C2HEST score at follow-up in assessing the risk of incident AF.Methods:A comprehensive database established by the information management and big data center of Peking University Third Hospital group was applied.Patients who did not have AF at baseline were enrolled.Newly-onset comorbidities were identified during follow-up.The dynamic change of the C2HEST score at baseline and follow-up were analyzed.The baseline and follow-up C2HEST scores were compared in predicting incident AF.Results:A total of 120 133 patients were included in the analysis.During 346 400 patient-years,2 304 developed incident AF(0.67 per 100 patient-years).The C2HEST score increased significantly during follow-up,especially for those who developed incident AF(from 1.62-2.96).A significant proportion of patients had newly-diagnosed comorbidities(61.9％and 14.6％with delta-C2HEST ≥ 1 in AF and non-AF,respectively).The major newly occurred comorbidities were heart failure(22.4％)and coronary artery disease(20.2％)for AF patients and hypertension for non-AF patients(7.5％).The follow-up C2HEST score showed improved performance compared with the baseline C2HEST score,assessed by area under curves(0.874 vs.0.758),decision curve analysis,and positive net reclassification index(24.7％).Conclusions:In this hospitalized population,the risk for the development of incident AF is not static and increases with the accumulation of new comorbidities and aging.The C2HEST score at follow-up is more accurate in assessing individual risk of AF.
维普
万方数据