{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:09:26Z","timestamp":1788847766565,"version":"build-2803163510"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,7,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The C\n              <jats:sub>2<\/jats:sub>\n              HEST score (coronary artery disease or chronic obstructive pulmonary disease [1 point each]; hypertension [1 point]; elderly [age \u226575 years, 2 points]; systolic heart failure [2 points]; thyroid disease [hyperthyroidism, 1 point]) was initially proposed for predicting incident atrial fibrillation (AF) in the general population. Its performance in poststroke patients remains to be established, especially because patients at high risk for incident AF should be targeted for more comprehensive screening. This study aimed to evaluate this newly established incident AF prediction risk score in a post\u2013ischemic stroke population.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Validation was based on a hospital\u2010based nationwide cohort with 240\u00a0459 French post\u2013ischemic stroke patients. Kaplan\u2013Meier curves for incident rate of AF depict differences between varying risk categories. Discrimination of the C\n              <jats:sub>2<\/jats:sub>\n              HEST score was evaluated using the C index, the net reclassification index, integrated discriminatory improvement, and decision curve analysis. During 7.9\u00b111.5\u00a0months of follow\u2010up, 14\u00a0095 patients developed incident AF. The incidence of AF increased from 23.5 per 1000\u00a0patient\u2010years in patients with a C\n              <jats:sub>2<\/jats:sub>\n              HEST score of 0 to 196.8 per 1000\u00a0patient\u2010years in patients with a C\n              <jats:sub>2<\/jats:sub>\n              HEST score \u22656. Kaplan\u2013Meier curves showed a clear difference among different risk strata (log\u2010rank\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). The C\n              <jats:sub>2<\/jats:sub>\n              HEST score had good discrimination with a C index of 0.734 (95% CI, 0.732\u20130.736), which was better than the Framingham risk score and the CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              \u2010VASc score (congestive heart failure, hypertension, age \u226575 [doubled], diabetes mellitus, stroke [doubled], vascular disease, age 65 to 74 years, and female sex) (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001, respectively). The C\n              <jats:sub>2<\/jats:sub>\n              HEST score was also superior to the Framingham risk score and the CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              \u2010VASc score as shown by the net reclassification index, integrated discriminatory improvement (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001, respectively) and decision curve analysis.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The C\n              <jats:sub>2<\/jats:sub>\n              HEST score performed well in discriminating the individual risk of developing incident AF in a white European population hospitalized with previous ischemic stroke. This simple score may potentially be used as a risk stratification tool for decision making in relation to a screening strategy for AF in post\u2013ischemic stroke patients.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.012546","type":"journal-article","created":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T11:57:41Z","timestamp":1561463861000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":94,"title":["C\n            <sub>2<\/sub>\n            HEST Score and Prediction of Incident Atrial Fibrillation in Poststroke Patients: A French Nationwide Study"],"prefix":"10.1161","volume":"8","author":[{"given":"Yan\u2010Guang","family":"Li","sequence":"first","affiliation":[{"name":"Institute of Applied Health Research\rUniversity of Birmingham\rUnited Kingdom"},{"name":"Department of Cardiology\rChinese PLA Medical School\rChinese PLA General Hospital\rBeijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Bisson","sequence":"additional","affiliation":[{"name":"Service de Cardiologie\rCentre Hospitalier Universitaire et Facult\u00e9 de M\u00e9decine\rEA7505\rUniversit\u00e9 de Tours\rFrance"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Bodin","sequence":"additional","affiliation":[{"name":"Service de Cardiologie\rCentre Hospitalier Universitaire et Facult\u00e9 de M\u00e9decine\rEA7505\rUniversit\u00e9 de Tours\rFrance"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Herbert","sequence":"additional","affiliation":[{"name":"Service de Cardiologie\rCentre Hospitalier Universitaire et Facult\u00e9 de M\u00e9decine\rEA7505\rUniversit\u00e9 de Tours\rFrance"},{"name":"Service d'information m\u00e9dicale, d\u2019\u00e9pid\u00e9miologie et d\u2019\u00e9conomie de la sant\u00e9\rCentre Hospitalier Universitaire et Facult\u00e9 de M\u00e9decine\rEA7505\rUniversit\u00e9 de Tours\rFrance"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Grammatico\u2010Guillon","sequence":"additional","affiliation":[{"name":"Service d'information m\u00e9dicale, d\u2019\u00e9pid\u00e9miologie et d\u2019\u00e9conomie de la sant\u00e9\rCentre Hospitalier Universitaire et Facult\u00e9 de M\u00e9decine\rEA7505\rUniversit\u00e9 de Tours\rFrance"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyoung","family":"Joung","sequence":"additional","affiliation":[{"name":"Division of Cardiology\rDepartment of Internal Medicine\rYonsei University Health System\rSeoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Tang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology\rChinese PLA Medical School\rChinese PLA General Hospital\rBeijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. 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