The Framingham Heart Study
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:
  • had an occurrence of new-onset Atrial Fibrillation (AF)
  • not treated with warfarin at baseline
  • did not have a stroke, transient ischemic attack (TIA), or death within 30 days of AF diagnosis
  • without rheumatic mitral stenosis
Predictors
  • Age
  • Gender
  • Systolic blood pressure
  • Prior stroke or ischemic attack
  • Diabetes
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 ---
Interactive Risk Score Calculator
Download an Excel spreadsheet version
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
 
0 %

Your 5-Year Risk of Stroke
 
0%

Comparative Risk of Stroke Comparative Risks of Stroke for same age and gender (lowest stroke risk=normal SBP (<120), no diabetes, prior stroke or TIA
 
0%

Your 5-Year Risk of Stroke or Death
 
0%

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