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Atrial ectopy as a mediator of the association between race and atrial fibrillation.
Tuesday,2018-01-16 17:02 America/Los_Angeles — ecterry
| Title | Atrial ectopy as a mediator of the association between race and atrial fibrillation. |
| Publication Type | Journal Article |
| Year of Publication | 2017 |
| Authors | Christensen, MA, Nguyen, KT, Stein, PK, Fohtung, RB, Soliman, EZ, Dewland, TA, Vittinghoff, E, Psaty, BM, Heckbert, SR, Marcus, GM |
| Journal | Heart Rhythm |
| Volume | 14 |
| Issue | 12 |
| Pagination | 1856-1861 |
| Date Published | 2017 Dec |
| ISSN | 1556-3871 |
| Abstract | <p><b>BACKGROUND: </b>Blacks have a lower risk of atrial fibrillation (AF) despite having more AF risk factors, but the mechanism remains unknown. Premature atrial contraction (PAC) burden is a recently identified risk factor for AF.</p><p><b>OBJECTIVE: </b>The purpose of this study was to determine whether the burden of PACs explains racial differences in AF risk.</p><p><b>METHODS: </b>PAC burden (number per hour) was assessed by 24-hour ambulatory electrocardiographic (ECG) monitoring in a randomly selected subset of patients in the Cardiovascular Health Study. Participants were followed prospectively for the development of AF, diagnosed by study ECG and hospital admission records.</p><p><b>RESULTS: </b>Among 938 participants (median age 73 years; 34% black; 58% female), 206 (22%) developed AF over a median follow-up of 11.0 years (interquartile range 6.1-13.4). After adjusting for age, sex, body mass index, coronary disease, congestive heart failure, diabetes, hypertension, alcohol consumption, smoking status, and study site, black race was associated with a 42% lower risk of AF (hazard ratio 0.58, 95% confidence interval [CI] 0.40-0.85; P = .005). The baseline PAC burden was 2.10 times (95% CI 1.57-2.83; P <.001) higher in whites than blacks. There was no detectable difference in premature ventricular contraction (PVC) burden by race. PAC burden mediated 19.5% (95% CI 6.3-52.5) of the adjusted association between race and AF.</p><p><b>CONCLUSION: </b>On average, whites exhibited more PACs than blacks, and this difference statistically explains a modest proportion of the differential risk of AF by race. The differential PAC burden, without differences in PVCs, by race suggests that identifiable common exposures or genetic influences might be important to atrial pathophysiology.</p> |
| DOI | 10.1016/j.hrthm.2017.09.034 |
| Alternate Journal | Heart Rhythm |
| PubMed ID | 29110996 |
| PubMed Central ID | PMC5712237 |
| Grant List | U01 HL080295 / HL / NHLBI NIH HHS / United States U01 HL130114 / HL / NHLBI NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States R25 MD006832 / MD / NIMHD NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States |
ePub date:
17/12