RT Journal Article
T1 Predictive model for atrial fibrillation in hypertensive diabetic patients.
A1 Abellana, Rosa
A1 Gonzalez-Loyola, Felipe
A1 Verdu-Rotellar, Jose-Maria
A1 Bustamante, Alejandro
A1 Palà, Elena
A1 Clua-Espuny, Josep Lluis
A1 Montaner, Joan
A1 Pedrote, Alonso
A1 Del Val-Garcia, Jose Luis
A1 Ribas Segui, Domingo
A1 Muñoz, Miguel Angel
K1 atrial fibrillation
K1 diabetes
K1 hypertension
K1 incidence
K1 prediction models
AB Several scores to identify patients at high risk of suffering atrial fibrillation have been developed. Their applicability in hypertensive diabetic patients, however, remains uncertain. Our aim is to develop and validate a diagnostic predictive model to calculate the risk of developing atrial fibrillation at five years in a hypertensive diabetic population. The derivation cohort consisted of patients with both hypertension and diabetes attended in any of the 52 primary healthcare centres of Barcelona; the validation cohort came from the 11 primary healthcare centres of Terres de l'Ebre (Catalonia South) from January 2013 to December 2017. Multivariable Cox regression identified clinical risk factors associated with the development of atrial fibrillation. The overall performance, discrimination and calibration of the model were carried out. The derivation data set comprised 54 575 patients. The atrial fibrillation rate incidence was 15.3 per 1000 person/year. A 5-year predictive model included age, male gender, overweight, heart failure, valvular heart disease, peripheral vascular disease, chronic kidney disease, number of antihypertensive drugs, systolic and diastolic blood pressure, heart rate, thromboembolism, stroke and previous history of myocardial infarction. The discrimination of the model was good (c-index = 0.692; 95% confidence interval, 0.684-0.700), and calibration was adequate. In the validation cohort, the discrimination was lower (c-index = 0.670). The model accurately predicts future atrial fibrillation in a population with both diabetes and hypertension. Early detection allows the prevention of possible complications arising from this disease.
YR 2021
FD 2021-06-19
LK http://hdl.handle.net/10668/18022
UL http://hdl.handle.net/10668/18022
LA en
DS RISalud
RD Apr 13, 2025