Document Detail


Racial differences in atrial fibrillation prevalence and left atrial size.
MedLine Citation:
PMID:  20227049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Previous studies relying on clinical care data have suggested that atrial fibrillation is less common in African Americans than Caucasians, but the mechanism remains unknown. Clinical care may itself vary by race, potentially affecting the accuracy of atrial fibrillation ascertainment in studies relying on clinical data. We sought to examine racial differences in atrial fibrillation prevalence determined by protocol-driven electrocardiograms (ECGs) obtained in prospective cohort studies and to study racial differences in echocardiographic characteristics.
METHODS: We pooled primary data from 3 cohort studies with atrial fibrillation adjudicated from study protocol ECGs and documentation of potentially important confounders: the Heart and Soul Study (n=1014), the Heart and Estrogen-Progestin Replacement Study (n=2673), and The Osteoporotic Fractures in Men Sleep Study (n=2911). Left atrial anatomic dimensions were compared among races from sinus rhythm echocardiograms in the Heart and Soul Study.
RESULTS: Of the 6611 participants, 268 (4%) had atrial fibrillation: Caucasians had the highest prevalence (5%), and African Americans had the lowest (1%; P<.001 for each compared with all other races). After adjustment for potential confounders, Caucasians had a 3.8-fold greater odds of having atrial fibrillation than African Americans (95% confidence interval, 1.6-8.8, P=.002). Although ventricular and atrial volumes and function were similar in Caucasians and African Americans, Caucasians had a 2 mm larger anterior-posterior left atrial diameter after adjusting for potential confounders (95% confidence interval, 1-3 mm, P<.001).
CONCLUSION: ECG confirmed atrial fibrillation is more common in Caucasians than in African Americans, which might be related to the larger left atrial diameter observed in Caucasians.
Authors:
Gregory M Marcus; Jeffrey E Olgin; Mary Whooley; Eric Vittinghoff; Katie L Stone; Reena Mehra; Stephen B Hulley; Nelson B Schiller
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-03-11
Journal Detail:
Title:  The American journal of medicine     Volume:  123     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-05     Completed Date:  2010-04-22     Revised Date:  2014-09-12    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  375.e1-7     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Atrial Fibrillation / genetics*,  pathology
Cohort Studies
Continental Population Groups*
Female
Heart Atria / pathology*
Humans
Male
Grant Support
ID/Acronym/Agency:
KL2RR024130/RR/NCRR NIH HHS; R01 HL070837/HL/NHLBI NIH HHS; R01 HL070838/HL/NHLBI NIH HHS; R01 HL070839/HL/NHLBI NIH HHS; R01 HL070841/HL/NHLBI NIH HHS; R01 HL070842/HL/NHLBI NIH HHS; R01 HL070847/HL/NHLBI NIH HHS; R01 HL070848/HL/NHLBI NIH HHS; R01 HL071194/HL/NHLBI NIH HHS; R01 HL079235/HL/NHLBI NIH HHS; R01 HL079235/HL/NHLBI NIH HHS; R01 HL079235-01A1/HL/NHLBI NIH HHS; U01 AG18197/AG/NIA NIH HHS; U01 AR45580/AR/NIAMS NIH HHS; U01 AR45583/AR/NIAMS NIH HHS; U01 AR45614/AR/NIAMS NIH HHS; U01 AR45632/AR/NIAMS NIH HHS; U01 AR45647/AR/NIAMS NIH HHS; U01 AR45654/AR/NIAMS NIH HHS; U01-AG027810/AG/NIA NIH HHS; UL1 RR024140/RR/NCRR NIH HHS
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