We provide a downloadable Excel spreadsheet that uses data from the Framingham Heart Study to estimate the risk of adverse outcomes following first occurrence of atrial fibrillation (AF). Information about the development of this risk prediction algorithm is provided in the citation below. The specific outcomes we estimate are:
- The 5-year risk of stroke using the baseline risk factors: age, gender, systolic blood pressure, diabetes mellitus, and prior stroke or transient ischemic attack.
- The 5-year risk of stroke or death using the baseline risk factors: age, systolic blood pressure, diabetes mellitus, prior heart failure or myocardial infarction, cigarette smoking, significant heart murmur, and electrocardiographic left ventricular hypertrophy. Users of this risk algorithm should be aware of the following caveats:
1. The risk scores are not applicable to persons:
- With rheumatic mitral stenosis or prior stroke or transient ischemic attack in the setting of AF, because there is broad consensus that these patients are at very high risk of events.
- On warfarin.
- With stroke, transient ischemic attack, or death within the first 30 days of AF-onset.
2. Echocardiographic findings are not included in the risk scores. These scores may underestimate the risk for individuals with significant left ventricular dysfunction.
3. For some of the age-risk factor groups in Framingham, the numbers of events are quite small. Therefore, the estimates of risk for those groups may lack precision.
4. These risk scores have not been tested in other study populations. The Framingham Heart Study participants are almost all white. The accuracy of the Framingham AF risk scores in other ethnicities has not yet been tested. This website will be updated as information on the performance of these risk scores in other settings becomes available.
This risk score should not take the place of clinical judgment or a careful medical examination.
Source: Wang TJ, Massaro JM, Levy D, Vasan RS, Wolf PA, D'Agostino RB, Larson MG, Kannel WB, Benjamin EJ. A Risk Score for Predicting Stroke or Death for Individuals with New-Onset Atrial Fibrillation in the Community: The Framingham Heart Study. JAMA 2003;290:1049-1056.
Click here for the spreadsheet. (Please note that this is an Excel spread sheet.)
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