Arrhythmias & electrophysiologyDiagnostic or prognostic study
Biomarker-Based Model for Prediction of Ischemic Stroke in Patients With Atrial Fibrillation
- Prognostic model development and validation study
Authors' conclusion
The biomarker-based ABC-AF risk scores for the risk of total and ischemic stroke were well calibrated, showed better discrimination than clinical risk scores in predicting total and ischemic stroke, and provided meaningful decision support for stroke-prevention treatments in patients with AF.
Study context
- Population
- Patients with atrial fibrillation (AF) assigned to direct oral anticoagulants (DOACs) or warfarin756 stroke/SEE
- Participants
- 26,452 patients
- Comparison
- ABC-AF risk scores vs ATRIA and CHA2DS2-VASc
- Outcome
- Discrimination (C-index) for total stroke/SEE and ischemic stroke/SEE
Performance
As reported in the abstract
Total stroke/SEE, C-index
ABC-AF-stroke
0.667
C-index · 95% CI 0.648–0.687
ATRIA
0.632
C-index · 95% CI 0.612–0.652
CHA2DS2-VASc
0.614
C-index · 95% CI 0.594–0.633
ABC-AF-stroke vs ATRIA: P < 0.001 · ABC-AF-stroke vs CHA2DS2-VASc: P < 0.001
Further findings
C-index
| Outcome | ABC-AF-stroke | ABC-AF-istroke | ATRIA | CHA2DS2-VASc | P value |
|---|---|---|---|---|---|
| Ischemic stroke/SEE, C-index — ABC-AF-istroke vs ATRIA | Not reported in the abstract | 0.677 (95% CI 0.654–0.700) | 0.642 (95% CI 0.618–0.666) | 0.624 (95% CI 0.601–0.647) | P < 0.001 |
| Ischemic stroke/SEE, C-index — ABC-AF-istroke vs CHA2DS2-VASc | P < 0.001 |
- Ischemic stroke/SEE, C-index: 534 ischemic stroke/SEE
Calibration, subgroups, decision curves
- Good calibration for total and ischemic stroke
- Results consistent in relevant subgroups
- Decision curve analyses showed net benefit at stroke-prevention thresholds
Original publication
Biomarker-Based Model for Prediction of Ischemic Stroke in Patients With Atrial Fibrillation. J Am Coll Cardiol. Published 25 March 2025. doi:10.1016/j.jacc.2024.11.052
Summarised from the published abstract; every number is checked against it