Stroke or Death after Atrial Fibrillation

(based on Wang TJ, Massaro JM, Levy D, Vasan RS, Wolf PA, D'Agostino RB, Larson MG, Kannel WB, Benjamin EJ. A risk score for predicting stroke or death in individuals with new-onset atrial fibrillation in the community: the Framingham Heart Study. JAMA. 2003;290:1049-1056.)

Outcome
Stroke or death

Duration of follow-up
Maximum of 10 years; mean 4 years; 5-year risk estimated

Population of interest
705 individuals aged 54 - 94 years from the Original and Offspring Cohorts meeting the following criteria:

Predictors

Risk Score Calculator

Interactive Excel spreadsheet

Score Sheet

Step 1
Age, y Points
55 0
56 1
57 2
58-59 3
60 4
61 5
62 6
63 7
64-65 8
66 9
67 10
68 11
69 12
70-71 13
72 14
73 15
74 16
75 17
76-77 18
78 19
79 20
80 21
81 22
82-83 23
84 24
85 25
86 26
87 27
88 28
89 29
90-91 30
92 31
93 32
94 33
 
Step 2
Systolic Blood
Pressure, mm Hg
Points
<120 0
120-139 1
140-159 2
160-179 3
>179 5
 
Step 3
Diabetes Points
No 0
Yes 4
 
Step 4
Smoker Points
No 0
Yes 5
 
Step 5
Prior MI or CHF Points
No 0
Yes 6
 
Step 6
Murmur Points
No 0
Yes 4
 
Step 7
ECG LVH Points
No 0
Yes 2
 

Step 8

Add Up Points From Steps 1 Through 7
Look Up Predicted 5-Year Risk of Stroke or Death in Table

Predicted 5-year Risk of Stroke or Death
Total Points 5-Year Risk, %
0 8
1 9
2 10
3 10
4 11
5 12
6 13
7 15
8 16
9 17
10 19
11 20
12 22
13 24
14 26
15 28
16 30
17 32
18 35
19 37
20 40
21 43
22 46
23 49
24 52
25 55
26 58
27 61
28 65
29 68
30 71
31 75
32 78
≥33 >80
 
Means and Cox Regression Coefficients
Variables Cox Regression Coefficient Risk Factor Mean
Age, per y 0.075673   75
Systolic Blood Pressure, per mmHg 0.006062 146
Smoking 0.492189 0.18
Diabetes Mellitus 0.333309 0.15
Prior CHF or MRI 0.503179 0.34
Significant Murmur 0.355479 0.13
ECG LVH 0.167387 0.15
Baseline Survival at 5 years, S0(5) 0.522500 ---
 
Risk Stroke Calculator
Gender:
M   F
Age:
Systolic Blood Pressure mm Hg:
Cigarette Smoker in Past Year:
Yes   No
Diabetes:
Yes   No
Prior Stroke/Transient Ischemic Attack (TIA):
Yes   No
History of Congestive Heart Failure or Myocardial Infarction:
Yes   No
Significant Murmur (grade 3/6 or higher systolic, any diastolic):
Yes   No
Electrocardiographic Left Ventricular Hypertrophy (LVH):
Yes   No
5-Year Risk of Stroke
 
0%
Your risk
 
0%
Comparative
Comparative Risks of Stroke for same age and gender (lowest stroke risk=normal SBP (<120), no diabetes, prior stroke or TIA
5-Year Risk of Stroke or Death
 
0%
Your risk
 
0%
Comparative
Comparative Risks of Stroke or Death for same age and gender (lowest stroke/ death risk=normal SBP (<120), no smoking, diabetes, CHF/MI, murmur, or LVH