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Ashburner JM, Wang X, Li X, et al. Re-CHARGE-AF: Recalibration of the CHARGE-AF Model for Atrial Fibrillation Risk Prediction in Patients With Acute Stroke. J Am Heart Assoc. 2021;10(21):e022363doi: 10.1161/JAHA.121.022363.
Ashburner, J. M., Wang, X., Li, X., Khurshid, S., Ko, D., Trisini Lipsanopoulos, A., Lee, P. R., Carmichael, T., Turner, A. C., Jackson, C., Ellinor, P. T., Benjamin, E. J., Atlas, S. J., Singer, D. E., Trinquart, L., Lubitz, S. A., & Anderson, C. D. (2021). Re-CHARGE-AF: Recalibration of the CHARGE-AF Model for Atrial Fibrillation Risk Prediction in Patients With Acute Stroke. Journal of the American Heart Association, 10(21), e022363. https://doi.org/10.1161/JAHA.121.022363
Ashburner, Jeffrey M, et al. "Re-CHARGE-AF: Recalibration of the CHARGE-AF Model for Atrial Fibrillation Risk Prediction in Patients With Acute Stroke." Journal of the American Heart Association vol. 10,21 (2021): e022363. doi: https://doi.org/10.1161/JAHA.121.022363
Ashburner JM, Wang X, Li X, Khurshid S, Ko D, Trisini Lipsanopoulos A, Lee PR, Carmichael T, Turner AC, Jackson C, Ellinor PT, Benjamin EJ, Atlas SJ, Singer DE, Trinquart L, Lubitz SA, Anderson CD. Re-CHARGE-AF: Recalibration of the CHARGE-AF Model for Atrial Fibrillation Risk Prediction in Patients With Acute Stroke. J Am Heart Assoc. 2021 Nov 02;10(21):e022363. doi: 10.1161/JAHA.121.022363. Epub 2021 Oct 20. PMID: 34666503; PMCID: PMC8751842.
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J Am Heart Assoc. 2021 Nov 02;10(21):e022363. doi: 10.1161/JAHA.121.022363. Epub 2021 Oct 20.

Re-CHARGE-AF: Recalibration of the CHARGE-AF Model for Atrial Fibrillation Risk Prediction in Patients With Acute Stroke.

Journal of the American Heart Association

Jeffrey M Ashburner, Xin Wang, Xinye Li, Shaan Khurshid, Darae Ko, Ana Trisini Lipsanopoulos, Priscilla R Lee, Taylor Carmichael, Ashby C Turner, Corban Jackson, Patrick T Ellinor, Emelia J Benjamin, Steven J Atlas, Daniel E Singer, Ludovic Trinquart, Steven A Lubitz, Christopher D Anderson

Affiliations

  1. Division of General Internal Medicine Massachusetts General Hospital Boston MA.
  2. Department of Medicine Harvard Medical School Boston MA.
  3. Cardiovascular Research Center Massachusetts General Hospital Boston MA.
  4. Division of Cardiology Massachusetts General Hospital Boston MA.
  5. Section of Cardiovascular Medicine Boston University School of Medicine Boston MA.
  6. Department of Neurology Massachusetts General Hospital & Harvard Medical School Boston MA.
  7. Jackson Heart StudyTougaloo College Tougaloo MS.
  8. Cardiac Arrhythmia Service Massachusetts General Hospital Boston MA.
  9. Boston University and National HeartLung, and Blood Institute's Framingham Heart Study Framingham MA.
  10. Department of Medicine Department of Epidemiology Sections of Preventive Medicine and Cardiovascular Medicine Boston University School of MedicineBoston University School of Public Heath Boston MA.
  11. Department of Biostatistics Boston University School of Public Health Boston MA.
  12. Department of Neurology Brigham and Women's Hospital Boston MA.

PMID: 34666503 PMCID: PMC8751842 DOI: 10.1161/JAHA.121.022363

Abstract

Background Performance of existing atrial fibrillation (AF) risk prediction models in poststroke populations is unclear. We evaluated predictive utility of an AF risk model in patients with acute stroke and assessed performance of a fully refitted model. Methods and Results Within an academic hospital, we included patients aged 46 to 94 years discharged for acute ischemic stroke between 2003 and 2018. We estimated 5-year predicted probabilities of AF using the Cohorts for Heart and Aging Research in Genomic Epidemiology for Atrial Fibrillation (CHARGE-AF) model, by recalibrating CHARGE-AF to the baseline risk of the sample, and by fully refitting a Cox proportional hazards model to the stroke sample (Re-CHARGE-AF) model. We compared discrimination and calibration between models and used 200 bootstrap samples for optimism-adjusted measures. Among 551 patients with acute stroke, there were 70 incident AF events over 5 years (cumulative incidence, 15.2%; 95% CI, 10.6%-19.5%). Median predicted 5-year risk from CHARGE-AF was 4.8% (quartile 1-quartile 3, 2.0-12.6) and from Re-CHARGE-AF was 16.1% (quartile 1-quartile 3, 8.0-26.2). For CHARGE-AF, discrimination was moderate (C statistic, 0.64; 95% CI, 0.57-0.70) and calibration was poor, underestimating AF risk (Greenwood-Nam D'Agostino chi-square,

Keywords: atrial fibrillation; ischemic stroke; predicted risk

References

  1. Open Heart. 2021 Jan;8(1): - PubMed
  2. N Engl J Med. 2003 Sep 11;349(11):1019-26 - PubMed
  3. J Am Heart Assoc. 2019 Jul 2;8(13):e012546 - PubMed
  4. Circ Arrhythm Electrophysiol. 2021 Jan;14(1):e008997 - PubMed
  5. Stroke. 1994 Feb;25(2):333-7 - PubMed
  6. Med Decis Making. 2015 Feb;35(2):162-9 - PubMed
  7. Eur J Prev Cardiol. 2015 Jul;22(7):932-9 - PubMed
  8. J Clin Oncol. 2010 May 10;28(14):2411-7 - PubMed
  9. JACC Clin Electrophysiol. 2019 Nov;5(11):1331-1341 - PubMed
  10. N Engl J Med. 2014 Jun 26;370(26):2467-77 - PubMed
  11. Circulation. 2019 Jul 9;140(2):e125-e151 - PubMed
  12. Value Health. 2007 Mar-Apr;10(2):137-43 - PubMed
  13. J Clin Epidemiol. 2019 Jun;110:12-22 - PubMed
  14. JAMA Cardiol. 2016 Dec 1;1(9):1007-1013 - PubMed
  15. Am J Cardiol. 2017 Sep 1;120(5):786-791 - PubMed
  16. Stroke. 1996 Oct;27(10):1760-4 - PubMed
  17. PLoS Med. 2012;9(5):1-12 - PubMed
  18. Europace. 2020 May 1;22(5):684-694 - PubMed
  19. Stroke. 2014 Jul;45(7):2160-236 - PubMed
  20. Stroke. 2014 Feb;45(2):520-6 - PubMed
  21. Stat Med. 1996 Feb 28;15(4):361-87 - PubMed
  22. Stat Methods Med Res. 2016 Aug;25(4):1692-706 - PubMed
  23. Stroke. 2020 Jul;51(7):2244-2248 - PubMed
  24. J Clin Epidemiol. 2005 May;58(5):475-83 - PubMed
  25. BMC Med Res Methodol. 2014 Mar 19;14:40 - PubMed
  26. Am Heart J. 2016 Aug;178:45-54 - PubMed
  27. N Engl J Med. 2014 Jun 26;370(26):2478-86 - PubMed
  28. Proc AMIA Symp. 2002;:552-6 - PubMed
  29. J Am Heart Assoc. 2013 Mar 18;2(2):e000102 - PubMed
  30. Stat Med. 2015 May 10;34(10):1659-80 - PubMed
  31. BMC Med. 2019 Dec 16;17(1):230 - PubMed
  32. PLoS One. 2016 Apr 21;11(4):e0153103 - PubMed
  33. Stroke. 1991 Aug;22(8):983-8 - PubMed
  34. Am J Cardiol. 2021 May 15;147:44-51 - PubMed
  35. Diabetes Care. 2004 Oct;27(10):2299-305 - PubMed
  36. Ann Intern Med. 2009 Mar 3;150(5):325-35 - PubMed
  37. J Am Heart Assoc. 2016 Sep 26;5(9): - PubMed
  38. Lancet. 2014 Mar 15;383(9921):955-62 - PubMed
  39. Lancet Neurol. 2015 Apr;14(4):377-87 - PubMed
  40. J Gen Intern Med. 2006 Sep;21(9):973-8 - PubMed
  41. Stat Med. 2004 Aug 30;23(16):2567-86 - PubMed

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