Relative and absolute risks of all-cause and cause-specific deaths attributable to atrial fibrillation in middle-aged and elderly community dwellers. (1st April 2015)

• Record Type: Journal Article
• Authors: Ohsawa, Masaki; Okamura, Tomonori; Ogasawara, Kuniaki; Ogawa, Akira; Fujioka, Tomoaki; Tanno, Kozo; Yonekura, Yuki; Omama, Shinichi; Turin, Tanvir Chowdhury; Itai, Kazuyoshi; Ishibashi, Yasuhiro; Morino, Yoshihiro; Itoh, Tomonori; Miyamatsu, Naomi; Onoda, Toshiyuki; Kuribayashi, Toru; Makita, Shinji; Yoshida, Yuki; Nakamura, Motoyuki; Tanaka, Fumitaka; Ohta, Mutsuko; Sakata, Kiyomi; Okayama, Akira
• Is Part Of: International journal of cardiology. Volume 184(2015)
• Page Start: 692
• Page End: 698
• Publication Date: 2015-04-01
• Subjects: Atrial fibrillation -- Cardiovascular death -- Non-cardiovascular death -- Sudden cardiac death -- Relative risk -- Absolute risk difference; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2015.03.068
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: The relative and absolute risks of outcomes other than all-cause death (ACD) attributable to atrial fibrillation (AF) stratified age have not been sufficiently investigated. Methods: A prospective study of 23, 634 community dwellers aged 40 years or older without organic cardiovascular disease (AF = 335, non-AF = 23, 299) was conducted. Multivariate-adjusted rates, rate ratios (RRs) and excess deaths (EDs) for ACD, cardiovascular death (CVD) and non-cardiovascular death (non-CVD), and sex- and age-adjusted RR and ED in middle-aged (40 to 69) and elderly (70 years or older) for ACD, CVD, non-CVD, sudden cardiac death (SCD), stroke-related death (Str-D), neoplasm-related death (NPD), and infection-related death (IFD) attributable to AF were estimated using Poisson regression. Results: Multivariate-adjusted analysis revealed that AF significantly increased the risk of ACD (RR [95% confidence interval]:1.70 [1.23–2.95]) and CVD (3.86 [2.38–6.27]), but not non-CVD. Age-stratified analysis revealed that AF increased the risk of Str-D in middle-aged (14.5 [4.77–44.3]) and elderly individuals (4.92 [1.91–12.7]), SCD in elderly individuals (3.21 [1.37–7.51]), and might increase the risk of IFD in elderly individuals (2.02 [0.80–4.65], p = 0.098). The RR of CVD was higher in middle-aged versus elderly individuals (RRs, 6.19 vs. 3.57) but the absolute risk difference was larger in elderly individuals (EDs: 7.6 vs. 3.0 per 1000 person-years). Conclusions: Larger absolute risk differences for ACD and CVD attributable to AF among elderly people indicate that the absolute burden of AF is higher in elderly versus middle-aged people despite the relatively small RR.