Prevalence and prognostic significance of atrial fibrillation during 20-year follow-up of the renrew/paisley cohort

S. Stewart, C. C. Hart, D. J. Hole, J. J. McMurray

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Abstract

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia but there is a paucity of epidemiological data relating to AF within the UK. Methods: We examined the prevalence, co-factors and prognostic significance of AF within the original Renfrew/Paisley population cohort in Scotland. A total of 15,406 men and women were first screened in the early 1970's when aged 45 to 64 years and were subject to 20-years follow-up thereafter. Results: A total of 47 of 8.354 women (5.6/1000) and 53 of 7,052 men (7.5/1000) were found to be in AF at the time of initial examination. Prevalence of AF increased markedly with age in both men and women (rising from 2.8 and 3.4/1000 respectively in those aged 45 to 49 years and 9.5 and 10.1/1000 in those aged 60 to 64 years). AF was independently correlated with male gender (OR 1.8, 95% CIs 1.2, 2.8; p < 0.01). cardiomegally (OR 12.9, 95% CIs 8.3, 20.2; p < 0.001). bronchitis (OR 2.2. 95% CIs 1.1, 4.2: p < 0.05), left ventricular hypertrophy on ECG (OR 4.2, 95% CIs 1.5, 12.3; p < 0.01), myocardial ischaemia on ECG (OR 4.5. 95% CIs 2.7, 7.4; p < 0.001), past history of stroke (OR 3.9, 95% CIs 1.7, 8.7; p < 0.001) and a blood sugar level ≥ 7.0 mmol/L (OR 3.1, 95% CIs 1.6, 6.0; p < 0.001). During subsequent 20-year follow-up, both men and women initially found to be in AF had significantly worse unadjusted mortality rates compared to the remainder of the cohort (79% vs 28% in women and 72% vs 44% in men: p < 0.001). Individuals with AF were significantly more likely to die from a stroke-related death (15% vs 3.7%: p < 0.001). Independent of age, gender, social deprivation, respiratory, cardiac, smoking and diabetic status. AF was associated with an adjusted relative risk of 1.9 (95% CIs 1.5, 2.5; p < 0.001) for dying from any cause. Conclusions: In this Scottish population cohort, prevalence of AF was greater in men and increased markedly with age. During 20-year followup. AF was associated with an adjusted two-fold increased risk of death.

Original languageEnglish
JournalHeart
Volume83
Issue numberSUPPL. 1
Publication statusPublished - 1 May 2000
Externally publishedYes

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