{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:09:58Z","timestamp":1792735798103,"version":"4.5.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Validated risk prediction scores for incident heart failure (HF) in patients with atrial fibrillation are lacking. We aimed to externally validate the the HF prediction risk score derived from three large control randomized trials RE\u2010LY, AVERROES, and ACTIVE\u2010A (REACT\u2010HF) score and assess potential improvements by incorporating biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We included 2599 patients with atrial fibrillation without prior HF from the Swiss\u2010AF (Swiss Atrial Fibrillation) and BEAT\u2010AF (Basel Atrial Fibrillation) cohorts. We estimated the C statistics of the REACT\u2010HF score with Cox proportional hazards models and improved prediction by adding hs\u2010CRP (high\u2010sensitivity C\u2010reactive protein), NT\u2010proBNP (N\u2010terminal pro\u2010B\u2010type natriuretic peptide), and high\u2010sensitivity troponin T. The primary outcome was incident HF hospitalization within 2\u2009years. Secondary outcomes included cardiovascular death, a composite of incident HF hospitalization and cardiovascular death, and all\u2010cause death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">The mean age was 70.2\u00b110.3\u2009years, 29.1% were women, and 54.8% had paroxysmal atrial fibrillation. Across risk score quintiles, the incidence rates per 100 patient\u2010years increased for the primary outcome (0.27, 0.54, 1.00, 2.24, 5.49), cardiovascular death (0.00, 0.11, 0.10, 0.91, 2.01), the composite of cardiovascular death and first HF hospitalization (0.27, 0.65, 1.10, 3.09, 6.86), and all\u2010cause death (0.00, 0.65, 0.40, 1.56, 4.10). The estimated C statistic (95% CI) for the primary outcome was 0.76 (0.72\u20130.81). C statistics for the secondary outcomes were consistent. The biomarker\u2010enhanced model, including hs\u2010CRP and NT\u2010proBNP, improved the C statistic to 0.84 (0.80\u20130.87).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this external validation, the REACT\u2010HF risk score demonstrated good discrimination for predicting the first HF hospitalization within 2\u2009years of follow\u2010up. The addition of NT\u2010proBNP and hs\u2010CRP further improved the score. The REACT\u2010HF score may help identify patients with atrial fibrillation at risk for HF, aiding in preventive therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.043058","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T11:08:07Z","timestamp":1756465687000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["External Validation of the REACT\u2010HF Score for Predicting Heart Failure in Patients With Atrial Fibrillation"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4043-8061","authenticated-orcid":false,"given":"Giorgio","family":"Moschovitis","sequence":"first","affiliation":[{"name":"Cardiocentro Ticino Institute, Regional Hospital of Lugano","place":["Lugano, 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Basel","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0325-8993","authenticated-orcid":false,"given":"Steffen","family":"Blum","sequence":"additional","affiliation":[{"name":"University Hospital Basel, University of Basel","place":["Switzerland"]},{"name":"University Hospital Basel, University of Basel","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1171-7640","authenticated-orcid":false,"given":"Maria Luisa","family":"De Perna","sequence":"additional","affiliation":[{"name":"Cardiocentro Ticino Institute, Regional Hospital of Lugano","place":["Lugano, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Mayer\u2010Melchiorre","sequence":"additional","affiliation":[{"name":"Cardiocentro Ticino Institute, Regional Hospital of Lugano","place":["Lugano, 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