Author(s): Dewland TA, Olgin JE, Vittinghoff E, Marcus GM
Because the association between atrial fibrillation (AF) and race has only been rigorously compared in population-based studies that dichotomized participants as white or black, it is unclear whether white race confers elevated AF risk or black race affords AF protection.
Methods and Results—The Healthcare Cost and Utilization Project was used to identify patients receiving hospital-based care in California between January 1, 2005 and December 31, 2009. The association between race and incident AF was examined using Cox proportional hazards models. Interaction analyses were performed to elucidate the mechanism underlying the race-AF association. Among 13 967 949 patients, 375 318 incident AF episodes were observed over a median 3.2 (interquartile range 1.8–4.3) years. In multivariable Cox models adjusting for patient demographics and established AF risk factors, blacks (hazard ratio, 0.84; 95% confidence interval, 0.82–0.85; P<0.001), Hispanics (hazard ratio, 0.78; 95% confidence interval, 0.77–0.79; P<0.001), and Asians (hazard ratio, 0.78; 95% confidence interval, 0.77–0.79; P<0.001) each exhibited a lower AF risk compared with whites. AF risk among whites was disproportionately higher in the absence of acquired cardiovascular risk factors and diminished or reversed in the presence of comorbid diseases. Although Hispanics and Asians also had a lower adjusted risk of incident atrial flutter compared with whites, the risk of flutter was significantly higher among blacks.
Conclusions—In a large hospital-based cohort, whites have an increased risk of AF whether compared with blacks, Asians, or Hispanics. The heightened AF risk among whites is most pronounced in the absence of cardiovascular comorbidities.
Referred From: http://circ.ahajournals.org/content/128/23/2470
Author(s): Ott A, Breteler MM, de Bruyne MC, van Harskamp F, Grobbee DE
Author(s): Wolf PA, Abbott RD, Kannel WB
Author(s): Furberg CD, Psaty BM, Manolio TA, Gardin JM, Smith VE
Author(s): Wagner KH, Brath H
Author(s): Rizzo JA, Mallow P, Waters H, Cirrincione A
Author(s): Jorgensen HS, Nakayama H, Reith J, Raaschou HO, Olsen TS
Author(s): Fuster V, Ryden LE, Asinger RW, Cannom DS, Crijns HJ
Author(s): Benjamin EJ, Levy D, Vaziri SM, D\'Agostino RB, Belanger AJ
Author(s): Tsang TS, Petty GW, Barnes ME, O\'Fallon WM, Bailey KR
Author(s): Steger C, Pratter A, Martinek-Bregel M, Avanzini M, Valentin A
Author(s): Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB
Author(s): Thom T, Haase N, Rosamond W, Howard VJ, Rumsfeld J,
Author(s): Ball J, Carrington MJ, McMurray JJ, Stewart S
Author(s): Glader EL, Stegmayr B, Norrving B, Terént A, Hulter-Asberg K
Author(s): Sinner MF, Ellinor PT, Meitinger T, Benjamin EJ, Kääb S
Author(s): Hernandez MB, Asher CR, Hernandez AV, Novaro GM
Author(s): Gan R, Sacco RL, Kargman DE, Roberts JK, Boden-Albala B
Author(s): Ruigomez A, Johansson S, Wallander MA, Rodriguez LA
Author(s): Stewart S, Hart CL, Hole DJ, McMurray JJ
Author(s): Psaty BM, Manolio TA, Kuller LH, Kronmal RA, Cushman M
Author(s): Barnes ME, Miyasaka Y, Seward JB, Gersh BJ, Rosale s AG
Author(s): Dulli DA, Stanko H, Levine RL
Author(s): Lamassa M, Di Carlo A, Pracucci G, Basile AM, Trefoloni G
Author(s): Lin HJ, Wolf PA, Kelly-Hayes M, Beiser AS, Kase CS
Author(s): Friberg J, Buch P, Scharling H, Gadsbphioll N, Jensen GB
Author(s): Kim MH, Lin J, Hussein M, Battleman D
Author(s): Miyasaka Y, Barnes ME, Gersh BJ, Cha SS, Bailey KR,
Author(s): Wattigney WA, Mensah GA, Croft JB
Author(s): Keogh AM, Baron DW, Hickie JB
Author(s): Markides V, Schilling RJ