{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:59:40Z","timestamp":1787320780739,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,7,27]],"date-time":"2024-07-27T00:00:00Z","timestamp":1722038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The incidence of new\u2010onset atrial fibrillation (NOAF) is increasing in the last decades. NOAF is associated with worse long\u2010term prognosis. The C\n                      <jats:sub>2<\/jats:sub>\n                      HEST score has been recently proposed to stratify the risk of NOAF. Pooled data on the performance of the C\n                      <jats:sub>2<\/jats:sub>\n                      HEST score are lacking.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Systematic review and meta\u2010analysis of observational studies reporting data on NOAF according to the C\n                      <jats:sub>2<\/jats:sub>\n                      HEST score. We searched PubMed, Web of Science and Google scholar databases without time restrictions until June 2023 according to PRISMA guidelines. Meta\u2010analysis 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\u2009years. The prevalence of women ranged from 10.6 to 54.75%. The pooled analysis gave an AUC of .70 (95% CI .66\u2013.74). A subgroup analysis on studies from general population\/primary care yielded an AUC of 0.69 (95% CI 0.64\u20130.75). In the subgroup of patients with cardiovascular disease, the AUC was .71 (.69\u2013.79). The C\n                      <jats:sub>2<\/jats:sub>\n                      HEST score performed similarly in Asian (AUC .72, 95% CI .68\u2013.77), and in Western patients (AUC .68, 95% CI .62\u2013.75). The best performance was observed in studies with a mean age &lt;50\u2009years (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093,144,704 with 25,538 NOAF, AUC .78, 95% CI .76\u2013.79).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The C\n                      <jats:sub>2<\/jats:sub>\n                      HEST 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\u2010up, potentially leading to a reduction of AF\u2010related complications.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eci.14293","type":"journal-article","created":{"date-parts":[[2024,7,27]],"date-time":"2024-07-27T15:19:23Z","timestamp":1722093563000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Usefulness of the\n                    <scp>\n                      C\n                      <sub>2<\/sub>\n                      HEST\n                    <\/scp>\n                    score to predict new onset atrial fibrillation. A systematic review and meta\u2010analysis on &gt;11 million subjects"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6357-5213","authenticated-orcid":false,"given":"Daniele","family":"Pastori","sequence":"first","affiliation":[{"name":"Department of Clinical Internal, Anesthesiological, and Cardiovascular Sciences Sapienza University of Rome  Rome Italy"},{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University, Liverpool Heart and Chest Hospital  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9467-5903","authenticated-orcid":false,"given":"Danilo","family":"Menichelli","sequence":"additional","affiliation":[{"name":"Department of Clinical Internal, Anesthesiological, and Cardiovascular Sciences Sapienza University of Rome  Rome Italy"},{"name":"Department of General and Specialized Surgery \"Paride Stefanini\" Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9121-1887","authenticated-orcid":false,"given":"Yan\u2010Guang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology Beijing Anzhen Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Brogi","sequence":"additional","affiliation":[{"name":"Department of Clinical Internal, Anesthesiological, and Cardiovascular Sciences Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio Giuseppe","family":"Biccir\u00e8","sequence":"additional","affiliation":[{"name":"Department of General and Specialized Surgery \"Paride Stefanini\" Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Pignatelli","sequence":"additional","affiliation":[{"name":"Department of Clinical Internal, Anesthesiological, and Cardiovascular Sciences Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7104-5826","authenticated-orcid":false,"given":"Alessio","family":"Farcomeni","sequence":"additional","affiliation":[{"name":"Department of Economics and Finance University of Rome \u2018Tor Vergata\u2019  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. 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