(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 |
4 |
|
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 |
| 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 10 y |
0.0756 |
75 |
| Systolic Blood Pressure |
0.0058 |
146 |
| Diabetes mellitus |
0.3365 |
0.15 |
| Prior CHF or MI |
0.5007 |
0.34 |
| Smoking |
0.4947 |
0.18 |
| Significant Murmur |
0.3577 |
0.13 |
| ECG LVH |
0.1655 |
0.15 |
| Baseline Survival at 5 years, S0(5) |
0.5225 |
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