External Performance of the HAVOC Score for the Prediction of New Incident Atrial Fibrillation.

Details

Serval ID
serval:BIB_9F4E0735529A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
External Performance of the HAVOC Score for the Prediction of New Incident Atrial Fibrillation.
Journal
Stroke
Author(s)
Ntaios G., Perlepe K., Lambrou D., Sirimarco G., Strambo D., Eskandari A., Karagkiozi E., Vemmou A., Koroboki E., Manios E., Makaritsis K., Vemmos K., Michel P.
ISSN
1524-4628 (Electronic)
ISSN-L
0039-2499
Publication state
Published
Issued date
02/2020
Peer-reviewed
Oui
Volume
51
Number
2
Pages
457-461
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Background and Purpose- The HAVOC score (hypertension, age, valvular heart disease, peripheral vascular disease, obesity, congestive heart failure, coronary artery disease) was proposed for the prediction of atrial fibrillation (AF) after cryptogenic stroke. It showed good model discrimination (area under the curve, 0.77). Only 2.5% of patients with a low-risk HAVOC score (ie, 0-4) were diagnosed with new incident AF. We aimed to assess its performance in an external cohort of patients with embolic stroke of undetermined source. Methods- In the AF-embolic stroke of undetermined source dataset, we assessed the discriminatory power, calibration, specificity, negative predictive value, and accuracy of the HAVOC score to predict new incident AF. Patients with a HAVOC score of 0 to 4 were considered as low-risk, as proposed in its original publication. Results- In 658 embolic stroke of undetermined source patients (median age, 67 years; 44% women), the median HAVOC score was 2 (interquartile range, 3). There were 540 (82%) patients with a HAVOC score of 0 to 4 and 118 (18%) with a score of ≥5. New incident AF was diagnosed in 95 (14.4%) patients (28.8% among patients with HAVOC score ≥5 and 11.3% among patients with HAVOC score 0-4 [age- and sex-adjusted odds ratio, 2.29 (95% CI, 1.37-3.82)]). The specificity of low-risk HAVOC score to identify patients without new incident AF was 88.7%. The negative predictive value of low-risk HAVOC score was 85.1%. The accuracy was 78.0%, and the area under the curve was 68.7% (95% CI, 62.1%-73.3%). Conclusions- The previously reported low rate of AF among embolic stroke of undetermined source patients with low-risk HAVOC score was not confirmed in our cohort. Further assessment of the HAVOC score is warranted before it is routinely implemented in clinical practice.
Keywords
Adult, Age Factors, Aged, Aged, 80 and over, Area Under Curve, Atrial Fibrillation/complications, Atrial Fibrillation/epidemiology, Cohort Studies, Coronary Artery Disease/epidemiology, Female, Heart Failure/epidemiology, Heart Valve Diseases/epidemiology, Humans, Hypertension/epidemiology, Incidence, Intracranial Embolism/epidemiology, Intracranial Embolism/etiology, Ischemic Attack, Transient/epidemiology, Ischemic Attack, Transient/etiology, Male, Middle Aged, Obesity/epidemiology, Peripheral Vascular Diseases/epidemiology, Reproducibility of Results, Risk Assessment, atrial fibrillation, coronary artery disease, heart failure, hypertension, obesity
Pubmed
Web of science
Create date
09/01/2020 15:43
Last modification date
07/07/2020 6:20
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