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Published on: February 26, 2013
Predicting Atrial Fibrillation and Its Complications
1Division of Epidemiology and Community Health, School of Public Health, University of Minnesota.
Insights
Predictive models can identify individuals at risk for atrial fibrillation (AF) and stroke. Further research is needed to improve AF prediction and forecast complications, especially with novel anticoagulants.
Area of Science:
- Cardiology
- Clinical Epidemiology
Background:
- Atrial fibrillation (AF) is a prevalent arrhythmia linked to increased stroke risk.
- Validated predictive models using clinical data and biomarkers can identify at-risk individuals.
- Existing risk schemes aid in managing anticoagulation for stroke and bleeding in AF patients.
Purpose of the Study:
- To highlight the current capabilities and limitations in predicting AF and its complications.
- To identify areas for future research in predictive modeling for AF and related adverse events.
Main Methods:
- Review of existing validated predictive models for AF incidence and complications.
- Analysis of risk stratification schemes for stroke and bleeding in AF patients.
- Identification of gaps in current predictive capabilities.
Main Results:
- Predictive models show promise in diverse populations for AF and stroke risk.
- Established schemes guide oral anticoagulation decisions for stroke and bleeding.
- Significant gaps remain in predicting AF and its complications.
Conclusions:
- Refinement of AF prediction models is crucial for improving population health.
- Enhanced prediction of stroke and other complications in AF patients is needed.
- Development of predictive models for novel oral anticoagulants is essential.
Abstract:
Atrial fibrillation (AF) is a common cardiac arrhythmia associated with an increased risk of stroke and other complications. Identifying individuals at higher risk of developing AF in the community is now possible using validated predictive models that take into account clinical variables and circulating biomarkers. These models have shown adequate performance in racially and ethnically diverse populations. Similarly, risk stratification schemes predict incidence of ischemic stroke in persons with AF, assisting clinicians and patients in decisions regarding oral anticoagulation use. Complementary schemes have been developed to predict the risk of bleeding in AF patients taking vitamin K antagonists. However, major gaps exist in our ability to predict AF and its complications. Additional research should refine models for AF prediction and determine their value to improve population health and clinical outcomes, advance our ability to predict stroke and other complications in AF patients, and develop predictive models for bleeding events and other adverse effects in patients using non-vitamin K oral anticoagulants. (Circ J 2016; 80: 1061-1066).
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