Abstract 15548: Comparing the Prediction of Heart Failure Symptoms Using a Clinical Score Assessing Risk of Atrial Fibrillation (CHARGE-AF) to Traditional Heart Failure Risk Scores
Introduction: The CHARGE-AF score gives a 5 year risk of developing atrial fibrillation (AF). Heart failure (HF) shares similar risk factors to AF. The CHARGE-AF score shares similar characteristics to the ARIC HF score.
Hypothesis: The CHARGE-AF score is similar to the ARIC score in prediction of HF symptoms.
Methods: A community based study of participants’ ≥ 65 years were recruited if they had presence of risk factors for HF (hypertension (HTN), diabetes mellitus (DM), obesity etc). HF risk was assessed using the CHARGE-AF and ARIC. Baseline ECG and echocardiography was performed in all participants and functional outcome was assessed using the six minute walk test (SMWT). HF symptoms were assessed at follow up using the Framingham criteria. Receiver operator characteristic (ROC) curves were generated to compare both scores using the Hanley and McNeil method.
Results: Total of 503 patients (age 70.8±4.7 yrs, male 48% with follow up 12 months±3). The median CHARGE-AF and ARIC scores were 7.5% (3.8–11.3%) and 5.9% (2.6–9.3%). During follow up, 55 patients developed HF symptoms. Patients with new onset HF were older with higher rates of DM (p=0.041), HTN (p=0.036) and previous ischaemic heart disease (p=0.003). New onset HF was associated with impaired global longitudinal (p<0.001) and circumferential strain (p=0.039) as well as higher indexed left atrial volume (p=0.01) and left ventricular mass (p=0.002). SMWT was lower in patients with new onset HF 436.4 vs 480.4m (p=0.002). ROC curves showed a c-statistic for the ARIC score of 0.654 (0.577–0.730,p<0.001) and CHARGE-AF 0.646 (0.565–0.727,p<0.001). There was no statistically significant difference in area under the curve(AUC) between both scores(difference in AUC 0.008, SE of difference=0.060, p=0.89).
Conclusion: The CHARGE-AF score is a useful clinical tool in predicting HF symptoms in patients and appears to be as predictive as the ARIC score. In the community setting it is useful in assessing both AF and HF risk.
Author Disclosures: S. Ramkumar: None. H. Yang: None. Y. Wang: None. M. Nolan: None. K. Negishi: None. T.H. Marwick: None.
- © 2016 by American Heart Association, Inc.