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Impact of Awareness and Patterns of Nonhospitalized Atrial Fibrillation on the Risk of Mortality: The Reasons for Geographic And Racial Differences in Stroke (REGARDS) Study
Journal article   Open access

Impact of Awareness and Patterns of Nonhospitalized Atrial Fibrillation on the Risk of Mortality: The Reasons for Geographic And Racial Differences in Stroke (REGARDS) Study

Wesley T O'Neal, Jimmy T Efird, Suzanne E Judd, Leslie A McClure, Virginia J Howard, George Howard and Elsayed Z Soliman
Clinical cardiology (Mahwah, N.J.), v 39(2), pp 103-110
Feb 2016
DOI: https://doi.org/10.1002/clc.22501
PMID: 26880475
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1002/clc.22501View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Aged Asymptomatic Diseases Atrial Fibrillation - diagnosis Atrial Fibrillation - epidemiology Atrial Fibrillation - ethnology Atrial Fibrillation - mortality Awareness Cause of Death Chi-Square Distribution Electrocardiography Female Health Knowledge, Attitudes, Practice - ethnology Health Status Disparities Humans Incidence Kaplan-Meier Estimate Male Middle Aged Multivariate Analysis Proportional Hazards Models Risk Assessment Risk Factors Stroke - diagnosis Stroke - epidemiology Stroke - ethnology Stroke - mortality Time Factors United States - epidemiology
Although mortality associated with atrial fibrillation (AF) has been reported to decrease over prior decades, the mortality risk of asymptomatic, nonhospitalized AF has not been examined. Asymptomatic, nonhospitalized AF is associated with an increased risk of death. This analysis included 25,976 participants (mean age, 65 ± 9.4 years; 55% female; 38% black) from the Reasons for Geographic And Racial Differences (REGARDS) study. Atrial fibrillation was detected on the baseline electrocardiogram (ECG AF) or by self-reported history. Atrial fibrillation unawareness was defined as present if ECG evidence of the arrhythmia was detected but no self-reported history was reported. All-cause mortality was confirmed during follow-up through March 31, 2014. A total of 2208 (8.5%) participants had AF at baseline (ECG: n = 371/17%; self-reported: n = 1837/83%). Over a median follow-up of 7.6 years, 3481 deaths occurred. In a multivariable Cox regression model, AF was associated with a 32% increased risk of mortality (95% confidence interval [CI]: 1.19-1.46). Risk of death was higher among those with ECG AF (hazard ratio: 1.71, 95% CI: 1.42-2.07) compared with self-reported cases (hazard ratio: 1.15, 95% CI: 1.03-1.29). Those who were unaware of their AF diagnosis had a 94% increased risk of death (95% CI: 1.50-2.52) compared with AF participants who were aware of their diagnosis. Asymptomatic, nonhospitalized AF is associated with an increased risk of mortality in the general population. Mortality is higher in those with ECG-confirmed cases and among those who are unaware of their diagnosis.

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19 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
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