Association of Atrial Fibrillation With Incidence of Extracranial Systemic Embolic Events: The ARIC Study
Background Atrial fibrillation (AF) increases the risk of stroke and extracranial systemic embolic events (SEEs), but little is known about the magnitude of the association of AF with SEE. Methods and Results This analysis included 14 941 participants of the ARIC (Atherosclerosis Risk in Communities...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-09-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.016724 |
| _version_ | 1797229314123497472 |
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| author | Mengyuan Shi Lin Y. Chen Wobo Bekwelem Faye L. Norby Elsayed Z. Soliman Aniqa B. Alam Alvaro Alonso |
| author_facet | Mengyuan Shi Lin Y. Chen Wobo Bekwelem Faye L. Norby Elsayed Z. Soliman Aniqa B. Alam Alvaro Alonso |
| author_sort | Mengyuan Shi |
| collection | DOAJ |
| description | Background Atrial fibrillation (AF) increases the risk of stroke and extracranial systemic embolic events (SEEs), but little is known about the magnitude of the association of AF with SEE. Methods and Results This analysis included 14 941 participants of the ARIC (Atherosclerosis Risk in Communities) study (mean age, 54.2±5.8, 55% women, 74% White) without AF at baseline (1987–1989) followed through 2017. AF was identified from study ECGs, hospital discharges, and death certificates, while SEEs were ascertained from hospital discharges. CHA2DS2‐VASc was calculated at the time of AF diagnosis. Cox regression was used to estimate associations of incident AF with SEE risk in the entire cohort, and between CHA2DS2‐VASc score and SEE risk in those with AF. Among eligible participants, 3114 participants developed AF and 270 had an SEE (59 events in AF). Incident AF was associated with increased risk of SEE (hazard ratio [HR], 3.58; 95% CI, 2.57–5.00), after adjusting for covariates. The association of incident AF with SEE was stronger in women (HR, 5.26; 95% CI, 3.28–8.44) than in men (HR, 2.68; 95% CI, 1.66–4.32). In those with AF, higher CHA2DS2‐VASc score was associated with increased SEE risk (HR per 1‐point increase, 1.24; 95% CI, 1.05–1.47). Conclusions AF is associated with more than a tripling of the risk of SEE, with a stronger association in women than in men. CHA2DS2‐VASc is associated with SEE risk in AF patients, highlighting the value of the score to predict adverse outcomes and guide treatment decisions in people with AF. |
| first_indexed | 2024-04-24T15:10:37Z |
| format | Article |
| id | doaj.art-59081b99b9664f32b8e0f010cb58facc |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-24T15:10:37Z |
| publishDate | 2020-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-59081b99b9664f32b8e0f010cb58facc2024-04-02T11:31:39ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-09-0191810.1161/JAHA.120.016724Association of Atrial Fibrillation With Incidence of Extracranial Systemic Embolic Events: The ARIC StudyMengyuan Shi0Lin Y. Chen1Wobo Bekwelem2Faye L. Norby3Elsayed Z. Soliman4Aniqa B. Alam5Alvaro Alonso6Department of Epidemiology Rollins School of Public Health Emory University Atlanta GACardiovascular Division University of Minnesota Medical School Minneapolis MNHeart and Lung Institute of Utah Salt Lake City UTDivision of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MNEpidemiological Cardiology Research Center Department of Epidemiology and Prevention Wake Forest School of Medicine Winston‐Salem NCDepartment of Epidemiology Rollins School of Public Health Emory University Atlanta GADepartment of Epidemiology Rollins School of Public Health Emory University Atlanta GABackground Atrial fibrillation (AF) increases the risk of stroke and extracranial systemic embolic events (SEEs), but little is known about the magnitude of the association of AF with SEE. Methods and Results This analysis included 14 941 participants of the ARIC (Atherosclerosis Risk in Communities) study (mean age, 54.2±5.8, 55% women, 74% White) without AF at baseline (1987–1989) followed through 2017. AF was identified from study ECGs, hospital discharges, and death certificates, while SEEs were ascertained from hospital discharges. CHA2DS2‐VASc was calculated at the time of AF diagnosis. Cox regression was used to estimate associations of incident AF with SEE risk in the entire cohort, and between CHA2DS2‐VASc score and SEE risk in those with AF. Among eligible participants, 3114 participants developed AF and 270 had an SEE (59 events in AF). Incident AF was associated with increased risk of SEE (hazard ratio [HR], 3.58; 95% CI, 2.57–5.00), after adjusting for covariates. The association of incident AF with SEE was stronger in women (HR, 5.26; 95% CI, 3.28–8.44) than in men (HR, 2.68; 95% CI, 1.66–4.32). In those with AF, higher CHA2DS2‐VASc score was associated with increased SEE risk (HR per 1‐point increase, 1.24; 95% CI, 1.05–1.47). Conclusions AF is associated with more than a tripling of the risk of SEE, with a stronger association in women than in men. CHA2DS2‐VASc is associated with SEE risk in AF patients, highlighting the value of the score to predict adverse outcomes and guide treatment decisions in people with AF.https://www.ahajournals.org/doi/10.1161/JAHA.120.016724atrial fibrillationCHA2DS2‐VASc scoreextracranial systemic embolism |
| spellingShingle | Mengyuan Shi Lin Y. Chen Wobo Bekwelem Faye L. Norby Elsayed Z. Soliman Aniqa B. Alam Alvaro Alonso Association of Atrial Fibrillation With Incidence of Extracranial Systemic Embolic Events: The ARIC Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atrial fibrillation CHA2DS2‐VASc score extracranial systemic embolism |
| title | Association of Atrial Fibrillation With Incidence of Extracranial Systemic Embolic Events: The ARIC Study |
| title_full | Association of Atrial Fibrillation With Incidence of Extracranial Systemic Embolic Events: The ARIC Study |
| title_fullStr | Association of Atrial Fibrillation With Incidence of Extracranial Systemic Embolic Events: The ARIC Study |
| title_full_unstemmed | Association of Atrial Fibrillation With Incidence of Extracranial Systemic Embolic Events: The ARIC Study |
| title_short | Association of Atrial Fibrillation With Incidence of Extracranial Systemic Embolic Events: The ARIC Study |
| title_sort | association of atrial fibrillation with incidence of extracranial systemic embolic events the aric study |
| topic | atrial fibrillation CHA2DS2‐VASc score extracranial systemic embolism |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.016724 |
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