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Clinicians managing heart failure now have a powerful tool for prognosis. The latest research indicates that FIND-AF risk stratification provides significant value for patients with heart failure with reduced ejection fraction (HFrEF). Many of these patients suffer from atrial cardiomyopathy (AtCM) even before developing atrial fibrillation (AF). This study evaluated a health records biomarker to predict critical clinical outcomes.
Researchers examined 164 patients from the ECG-HF registry between 2010 and 2016. They identified patients with HFrEF and AtCM but without baseline AF. The team used sex-specific thresholds to categorize patients into high and low-risk groups. Subsequently, they followed these individuals until the end of 2019 to track composite outcomes. Specifically, they monitored incident AF, ischaemic stroke, and all-cause mortality.
The results were striking for high-risk individuals. High-risk patients experienced a composite outcome rate of 71.9%. In contrast, only 50.8% of low-risk patients reached the same endpoint. Consequently, the findings suggest that the biomarker remains a strong independent predictor. Moreover, the model outperformed the traditional CHA2DS2-VASc score in terms of discrimination. Specifically, it showed significantly better accuracy for predicting ischaemic stroke and mortality.
However, this exploratory study requires further external validation. Despite this limitation, the data supports early risk assessment in HFrEF populations. Identifying high-risk patients allows for more vigilant monitoring. Furthermore, it might facilitate early interventions to prevent stroke. Thus, incorporating this biomarker into clinical workflows could improve patient management strategies significantly.
FIND-AF risk stratification identifies HFrEF patients at high risk for stroke and atrial fibrillation. This allows doctors to prioritize intensive monitoring for those without baseline AF.
Yes, this study demonstrated that FIND-AF offers superior discrimination (AUC 0.735) compared to CHA2DS2-VASc (AUC 0.641) for composite outcomes and ischaemic stroke.
Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or a professional recommendation. Refer to the latest local and national guidelines for clinical practice.
References
Hsu JC et al. Stratifying prognosis in heart failure patients with reduced ejection fraction and atrial cardiomyopathy. ESC Heart Fail. 2026 May 21. doi: undefined. PMID: 42168766.
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