{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:55:07Z","timestamp":1787756107730,"version":"build-2784847793"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,10,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The risk of incident atrial fibrillation (AF) increases with accumulating risk factors. Baseline\u2010only risk assessment may not reflect the real risk of incident AF. We aimed to evaluate the performance of the dynamic change of the C\n              <jats:sub>2<\/jats:sub>\n              HEST score (C2: coronary artery disease\/chronic obstructive pulmonary disease (1 point each); H: hypertension (1 point); E: elderly (age \u226575\u2009years, 2 points); S: systolic\/diastolic heart failure (2 points); and T: thyroid disease (hyperthyroidism, 1 point) C\n              <jats:sub>2<\/jats:sub>\n              HEST) score to assess the risk of incident AF during follow\u2010up.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The present study data were retrieved from the Information Management and Big Data Center of Peking University Hospital Group. Patients without AF at baseline were enrolled. New\u2010onset comorbidities were recorded during follow\u2010up. The change in the C\n              <jats:sub>2<\/jats:sub>\n              HEST score was analyzed. The baseline and the change in C\n              <jats:sub>2<\/jats:sub>\n              HEST scores were compared for the prediction of incident AF.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 120\u2009133 patients were included in the final analysis. During 346\u2009400 patient\u2010years of follow\u2010up, 2304 developed incident AF (0.67 per 100 patient\u2010years). The mean C\n              <jats:sub>2<\/jats:sub>\n              HEST score increased significantly from 1.62 to 2.96 (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.05). A significant proportion of patients had newly diagnosed comorbidities (61.9% with \u2206C\n              <jats:sub>2<\/jats:sub>\n              HEST \u22651 in AF and 14.6% with C\n              <jats:sub>2<\/jats:sub>\n              HEST \u22651 in non\u2010AF). The change in C\n              <jats:sub>2<\/jats:sub>\n              HEST scores showed better performance compared with the baseline score, as assessed by area under curve analyses (\u2206C\n              <jats:sub>2<\/jats:sub>\n              HEST 0.821 [0.811\u20130.830], baseline 0.758 [0.747\u20130.769]), decision curve analysis, and positive net reclassification index.\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 risk for incident AF is not static and increases with the accumulation of new comorbidities. The change in C\n              <jats:sub>2<\/jats:sub>\n              HEST score had better prediction in assessing individual risk of incident AF compared with the baseline score.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.039231","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T11:15:55Z","timestamp":1758280555000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Dynamic Increase of the C\n            <sub>2<\/sub>\n            HEST Score in Relation to the Development of Incident Atrial Fibrillation: A Longitudinal Cohort Study"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9121-1887","authenticated-orcid":false,"given":"Yan\u2010Guang","family":"Li","sequence":"first","affiliation":[{"name":"Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Jie","family":"Liu","sequence":"additional","affiliation":[{"name":"Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Li","family":"Wang","sequence":"additional","affiliation":[{"name":"Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiao\u2010Yuan","family":"Li","sequence":"additional","affiliation":[{"name":"Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7618-2563","authenticated-orcid":false,"given":"Tao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Liu","sequence":"additional","affiliation":[{"name":"Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin\u2010Chao","family":"Wu","sequence":"additional","affiliation":[{"name":"Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Yin","sequence":"additional","affiliation":[{"name":"Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7246-5980","authenticated-orcid":false,"given":"Shao\u2010Min","family":"Chen","sequence":"additional","affiliation":[{"name":"Peking University Third Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Bai","sequence":"additional","affiliation":[{"name":"Peking University Third Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6357-5213","authenticated-orcid":false,"given":"Daniele","family":"Pastori","sequence":"additional","affiliation":[{"name":"Sapienza University of Rome","place":["Rome, Italy"]},{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Chest and Heart Hospital","place":["Liverpool, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Chest and Heart Hospital","place":["Liverpool, United Kingdom"]},{"name":"Aalborg University","place":["Aalborg, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5695-5058","authenticated-orcid":false,"given":"Yun\u2010Long","family":"Wang","sequence":"additional","affiliation":[{"name":"Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-022-00820-8"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.22.8.983"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.045204"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-18-0045"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-023-00857-3"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc22-0717"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2017.1407036"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.02.051"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.022363"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.027990"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(09)60443-8"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad615"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.055176"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.11.040"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac460"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad375"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.09.011"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.017519"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.907817"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2023.05.023"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2022-322076"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2023.131280"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9051493"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2019.07.016"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000001193"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.003347"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2021.04.014"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.124.039231","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T09:32:46Z","timestamp":1759915966000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.124.039231"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,7]]},"references-count":27,"journal-issue":{"issue":"19","published-print":{"date-parts":[[2025,10,7]]}},"alternative-id":["10.1161\/JAHA.124.039231"],"URL":"https:\/\/doi.org\/10.1161\/jaha.124.039231","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,7]]},"assertion":[{"value":"2024-10-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e039231"}}