Risk factors and a 3-month risk score for predicting pacemaker implantation in patients with atrial fibrillations
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Risk factors and a 3-month risk score for predicting pacemaker implantation in patients with atrial fibrillations. / Dalgaard, Frederik; Pallisgaard, Jannik Langtved; Lindhardt, Tommi Bo; Gislason, Gunnar; Blanche, Paul; Torp-Pedersen, Christian; Ruwald, Martin H.
In: Open Heart, Vol. 7, No. 1, e001125, 2020.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Risk factors and a 3-month risk score for predicting pacemaker implantation in patients with atrial fibrillations
AU - Dalgaard, Frederik
AU - Pallisgaard, Jannik Langtved
AU - Lindhardt, Tommi Bo
AU - Gislason, Gunnar
AU - Blanche, Paul
AU - Torp-Pedersen, Christian
AU - Ruwald, Martin H
N1 - © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2020
Y1 - 2020
N2 - Objectives: To identify risk factors and to develop a predictive risk score for pacemaker implantation in patients with atrial fibrillation (AF).Methods: Using Danish nationwide registries, patients with newly diagnosed AF from 2000 to 2014 were identified. Cox proportional-hazards regression computed HRs for risk factors of pacemaker implantation. A logistic regression was used to fit a prediction model for 3-month risk of pacemaker implantation and derived a risk score using 80% of the data and its predictive accuracy estimated using the remaining 20%.Results: Among 155 934 AF patients included, the median age (IQR) was 75 (65-83) and 51.3% were men. During a median follow-up time of 3.4 (1.2-5.0) years, 8348 (5.4%) patients received a pacemaker implantation. Risk factors of pacemaker implantation were (in order of highest risk first) age above 60 years, congenital heart disease, heart failure at age under 60 years, prior syncope, valvular AF, hypertension, ischaemic heart disease, male sex and diabetes mellitus. The derived risk score assigns points ranging from 1 to 14 to each of these risk factors. The 3-month risk of pacemaker implantation increased from 0.4% (95% CI: 0.2 to 0.8) at 1 point to 2.6% (95% CI: 1.9 to 3.6) at 18 points. Area under the receiver operator characteristics curve was 62.9 (95% CI: 60.3 to 65.5).Conclusion: We highlighted risk factors of pacemaker implantation in newly diagnosed AF patients and created a risk score. The clinical utility of the risk score needs further investigation.
AB - Objectives: To identify risk factors and to develop a predictive risk score for pacemaker implantation in patients with atrial fibrillation (AF).Methods: Using Danish nationwide registries, patients with newly diagnosed AF from 2000 to 2014 were identified. Cox proportional-hazards regression computed HRs for risk factors of pacemaker implantation. A logistic regression was used to fit a prediction model for 3-month risk of pacemaker implantation and derived a risk score using 80% of the data and its predictive accuracy estimated using the remaining 20%.Results: Among 155 934 AF patients included, the median age (IQR) was 75 (65-83) and 51.3% were men. During a median follow-up time of 3.4 (1.2-5.0) years, 8348 (5.4%) patients received a pacemaker implantation. Risk factors of pacemaker implantation were (in order of highest risk first) age above 60 years, congenital heart disease, heart failure at age under 60 years, prior syncope, valvular AF, hypertension, ischaemic heart disease, male sex and diabetes mellitus. The derived risk score assigns points ranging from 1 to 14 to each of these risk factors. The 3-month risk of pacemaker implantation increased from 0.4% (95% CI: 0.2 to 0.8) at 1 point to 2.6% (95% CI: 1.9 to 3.6) at 18 points. Area under the receiver operator characteristics curve was 62.9 (95% CI: 60.3 to 65.5).Conclusion: We highlighted risk factors of pacemaker implantation in newly diagnosed AF patients and created a risk score. The clinical utility of the risk score needs further investigation.
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Atrial Fibrillation/diagnosis
KW - Cardiac Pacing, Artificial
KW - Comorbidity
KW - Decision Support Techniques
KW - Denmark/epidemiology
KW - Female
KW - Health Status
KW - Humans
KW - Male
KW - Middle Aged
KW - Pacemaker, Artificial
KW - Predictive Value of Tests
KW - Registries
KW - Reproducibility of Results
KW - Risk Assessment
KW - Risk Factors
KW - Time Factors
U2 - 10.1136/openhrt-2019-001125
DO - 10.1136/openhrt-2019-001125
M3 - Journal article
C2 - 32257243
VL - 7
JO - Open Heart
JF - Open Heart
SN - 2398-595X
IS - 1
M1 - e001125
ER -
ID: 256572820