Repeated CHARGE-AF Score Assessments for Predicting Incident Atrial Fibrillation: A Longitudinal Analysis from the...

Area of Science:

• Cardiology
• Epidemiology
• Genomics

Background:

• The Cohorts for Heart and Aging Research in Genomic Epidemiology - Atrial Fibrillation (CHARGE-AF) score is a validated tool for estimating 5-year atrial fibrillation (AF) risk.
• Previous studies have established the utility of the CHARGE-AF score in predicting AF risk.

Purpose of the Study:

• To evaluate the utility of repeated CHARGE-AF scores for improving AF risk prediction.
• To determine if longitudinal CHARGE-AF score assessments enhance the accuracy of predicting incident AF.

Main Methods:

• Analysis of 10,188 participants from the Atherosclerosis Risk in Communities (ARIC) study with complete data from four clinic visits.
• Calculation of CHARGE-AF scores at each visit, with incident AF determined over a median follow-up of 19.5 years.
• Comparison of Cox regression models incorporating single vs. multiple CHARGE-AF scores to assess predictive discrimination and calibration.

Main Results:

• A single visit 4 CHARGE-AF score demonstrated strong association with incident AF (HR=1.14 per 1% increase).
• Addition of prior CHARGE-AF scores did not significantly improve model discrimination (C-statistic 0.702-0.703).
• Sex modified the association, with a stronger risk prediction for females.

Conclusions:

• A single, most recent CHARGE-AF score measurement provides robust predictive value for incident AF.
• Repeated CHARGE-AF score assessments offer limited incremental benefit for AF risk prediction.
• The most recent CHARGE-AF score is sufficient for AF risk assessment in clinical practice with longitudinal data.