Usefulness of the C2HEST score to predict new onset atrial fibrillation. A systematic review and meta-analysis on >11 million subjects

IF 4.4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Daniele Pastori, Danilo Menichelli, Yan-Guang Li, Tommaso Brogi, Flavio Giuseppe Biccirè, Pasquale Pignatelli, Alessio Farcomeni, Gregory Y. H. Lip
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引用次数: 0

Abstract

Background

The incidence of new-onset atrial fibrillation (NOAF) is increasing in the last decades. NOAF is associated with worse long-term prognosis. The C2HEST score has been recently proposed to stratify the risk of NOAF. Pooled data on the performance of the C2HEST score are lacking.

Methods

Systematic review and meta-analysis of observational studies reporting data on NOAF according to the C2HEST score. We searched PubMed, Web of Science and Google scholar databases without time restrictions until June 2023 according to PRISMA guidelines. Meta-analysis of the area under the curve (AUC) with 95% confidence interval (95% CI) and a sensitivity analysis according to setting of care and countries were performed.

Results

Of 360 studies, 17 were included in the analysis accounting for 11,067,496 subjects/patients with 307,869 NOAF cases. Mean age ranged from 41.3 to 71.2 years. The prevalence of women ranged from 10.6 to 54.75%. The pooled analysis gave an AUC of .70 (95% CI .66–.74). A subgroup analysis on studies from general population/primary care yielded an AUC of 0.69 (95% CI 0.64–0.75). In the subgroup of patients with cardiovascular disease, the AUC was .71 (.69–.79). The C2HEST score performed similarly in Asian (AUC .72, 95% CI .68–.77), and in Western patients (AUC .68, 95% CI .62–.75). The best performance was observed in studies with a mean age <50 years (n = 3,144,704 with 25,538 NOAF, AUC .78, 95% CI .76–.79).

Conclusion

The C2HEST score may be used to predict NOAF in primary and secondary prevention patients, and in patients across different countries. Early detection of NOAF may aid prompt initiation of management and follow-up, potentially leading to a reduction of AF-related complications.

Abstract Image

C2HEST 评分在预测新发心房颤动方面的实用性。对超过 1,100 万名受试者进行的系统回顾和荟萃分析
背景近几十年来,新发心房颤动(NOAF)的发病率不断上升。新发心房颤动与较差的长期预后有关。最近有人提出了 C2HEST 评分来对 NOAF 的风险进行分层。方法对根据 C2HEST 评分报告 NOAF 数据的观察性研究进行系统回顾和荟萃分析。根据 PRISMA 指南,我们在 2023 年 6 月之前对 PubMed、Web of Science 和 Google scholar 数据库进行了无时间限制的检索。我们对曲线下面积(AUC)和 95% 置信区间(95% CI)进行了元分析,并根据医疗环境和国家进行了敏感性分析。结果 在 360 项研究中,有 17 项被纳入分析,涉及 11,067,496 名受试者/患者,307,869 例 NOAF。平均年龄从 41.3 岁到 71.2 岁不等。女性发病率从 10.6% 到 54.75% 不等。汇总分析的 AUC 为 0.70(95% CI 0.66-0.74)。对普通人群/初级保健研究进行的亚组分析得出的 AUC 为 0.69(95% CI 0.64-0.75)。在心血管疾病患者亚组中,AUC 为 0.71(.69-.79)。C2HEST 评分在亚洲患者(AUC .72,95% CI .68-.77)和西方患者(AUC .68,95% CI .62-.75)中的表现相似。结论 C2HEST 评分可用于预测一级和二级预防患者以及不同国家患者的 NOAF。C2HEST评分可用于预测一级和二级预防患者以及不同国家患者的NOAF,早期发现NOAF有助于及时启动管理和随访,从而减少房颤相关并发症。
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来源期刊
CiteScore
9.50
自引率
3.60%
发文量
192
审稿时长
1 months
期刊介绍: EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.
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