Lip GYH, et al. - Given that for predicting incident AF, a simple clinical score, C₂HEST (C2: CAD / COPD (1 point each); H: Hypertension; E: Elderly (Age ≥ 75, doubled); S: Systolic HF (doubled); T: Thyroid disease (hyperthyroidism)) has been proposed, with good discrimination and internal calibration. Researchers sought to evaluate the performance of the C₂HEST score in determining patients who are at high risk for incident AF in a nationwide cohort study of all Danish citizens (aged ≥ 65 years). Five-year risks of new-onset AF of 11.8%, 14.2% and 13.6% was evident for ‘high risk’ individuals at age 65, 70 and 75, respectively, and the corresponding event rates were 2.99, 3.67, and 3.38 per 100 person-years, respectively. Multivariable analysis revealed that the greatest risk component of the C₂HEST score at all age cohorts was having two points for C (C2), that is both CAD and COPD followed by systolic heart failure (S) both with HRs up to 2.0. They observed an increased risk of new-onset AF in correlation with CAD or COPD alone (C1) or hypertension (H) corresponding to HR between 1.44 and 1.64. Findings support the association of a high-risk C₂HEST score stratum with a greater risk of new onset AF. They suggest considering these patients for more intensive efforts for screening and detection of incident AF.