Impact of Atrial Fibrillation on the Risk of Death

Ovid Technologies (Wolters Kluwer Health) - Tập 98 Số 10 - Trang 946-952 - 1998
Emelia J. Benjamin1,2,3,4,5, Philip A. Wolf1,2,3,4,5, Ralph B. D’Agostino1,2,3,4,5, Halit Silbershatz1,2,3,4,5, William B. Kannel1,2,3,4,5, Daniel Levy1,2,3,4,5
1Department of Mathematics, Boston University (R.B.D., H.S.), Boston, Mass
2Departments of Cardiology (E.J.B.), Preventive Medicine (E.J.B., P.A.W., D.L.), and Neurology (P.A.W.), Boston University School of Medicine, Boston, Mass
3Division of Cardiology and Clinical Epidemiology, Beth Israel Hospital, Boston, Mass (D.L.)
4From the National Heart, Lung, and Blood Institute’s Framingham Heart Study, National Institutes of Health, Framingham, Mass (E.J.B., P.A.W., R.B.D., H.S., W.B.K., D.L.); Departments of Cardiology (E.J.B.), Preventive Medicine (E.J.B., P.A.W., D.L.), and Neurology (P.A.W.), Boston University School of Medicine, Boston, Mass; Department of Mathematics, Boston University (R.B.D., H.S.), Boston, Mass; Division of Cardiology and Clinical Epidemiology, Beth Israel Hospital, Boston, Mass (D.L.); and...
5National Heart, Lung, and Blood Institute, Bethesda, Md (D.L.).

Tóm tắt

Background —Atrial fibrillation (AF) causes substantial morbidity. It is uncertain whether AF is associated with excess mortality independent of associated cardiac conditions and risk factors.

Methods and Results —We examined the mortality of subjects 55 to 94 years of age who developed AF during 40 years of follow-up of the original Framingham Heart Study cohort. Of the original 5209 subjects, 296 men and 325 women (mean ages, 74 and 76 years, respectively) developed AF and met eligibility criteria. By pooled logistic regression, after adjustment for age, hypertension, smoking, diabetes, left ventricular hypertrophy, myocardial infarction, congestive heart failure, valvular heart disease, and stroke or transient ischemic attack, AF was associated with an OR for death of 1.5 (95% CI, 1.2 to 1.8) in men and 1.9 (95% CI, 1.5 to 2.2) in women. The risk of mortality conferred by AF did not significantly vary by age. However, there was a significant AF-sex interaction: AF diminished the female advantage in survival. In secondary multivariate analyses, in subjects free of valvular heart disease and preexisting cardiovascular disease, AF remained significantly associated with excess mortality, with about a doubling of mortality in both sexes.

Conclusions —In subjects from the original cohort of the Framingham Heart Study, AF was associated with a 1.5- to 1.9-fold mortality risk after adjustment for the preexisting cardiovascular conditions with which AF was related. The decreased survival seen with AF was present in men and women and across a wide range of ages.

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Ovid Technologies (Wolters Kluwer Health)

Tập 98 Số 10

946-952

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