Thirty-Year Trends in the Incidence of Atrial Fibrillation: The ARIC Study.
Thirty-Year Trends in the Incidence of Atrial Fibrillation: The ARIC Study.
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DOI：
10.1161/jaha.121.023583
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发表时间：
2022-04-19
影响因子：
5.4
通讯作者：
Alonso, Alvaro
中科院分区：
文献类型：
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作者：
Ghelani, Kunali P.;Chen, Lin Yee;Norby, Faye L.;Soliman, Elsayed Z.;Koton, Silvia;Alonso, Alvaro
研究房颤（AF）发病率近期趋势的长期数据（总体以及性别和种族组）很少。我们评估了ARIC（社区动脉粥样硬化风险）研究队列中AF发病率的30年趋势，并探讨了这些趋势中的种族和性别差异。我们在ARIC队列中纳入了1987年至1989年来自4个美国社区的15343名年龄在45至64岁之间的无AF男性和女性。根据研究ECG、出院代码和2017年的死亡证明确定AF事件。我们计算了年龄和特定时期的房颤发病率（IR）。我们使用泊松回归计算了随时间推移的房颤IR比率，调整了年龄、性别和种族。在平均（SD）22年（8.4年）随访期间，共识别出3241例AF病例（黑人受试者599例，白色受试者2642例，女性1582例，男性1659例）。总体而言，ARIC队列中AF的IR为9.6/1000人-年（黑人受试者为6.9，白色受试者为10.5，女性为8.1，男性为11.6）。按时间段划分的年龄特异性IR未显示随时间的显著变化。在根据性别、人种和年龄组调整的模型中，与2012年至2017年相比，1987年至1991年的AF发生率没有显著变化（2012年至2017年与1987年至1991年相比，IR比为1.10 [95% CI，0.88-1.36]）。同样，在男性和女性或白色和黑人参与者中，未发现房颤率随时间变化的证据。尽管AF的IR随着年龄的增长而增加，但我们的分析提供的证据表明，1987年至2017年期间，美国黑人和白色个体的多中心队列中AF的总体IR并未随时间发生变化。
Long‐term data to study recent trends in the incidence of atrial fibrillation (AF), overall and among sex and race groups, are scarce. We evaluated the 30‐year trends in the incidence of AF in the ARIC (Atherosclerosis Risk in Communities) study cohort and explored race and sex differences in these trends. We included 15 343 men and women aged 45 to 64 years in 1987 to 1989 without AF from 4 US communities in the ARIC cohort. Incident AF was identified based on study ECGs, hospital discharge codes, and death certificates through 2017. We calculated age and period‐specific incidence rates (IRs) of AF. We used Poisson regression to calculate IR ratios of AF over time adjusting for age, sex, and race. A total of 3241 AF cases were identified during a mean (SD) follow‐up of 22 years (8.4 years) (599 in Black participants, 2642 in White participants, 1582 in women, and 1659 in men). Overall, the IR of AF in the ARIC cohort was 9.6 per 1000 person‐years (6.9 in Black participants, 10.5 in White participants, 8.1 in women, and 11.6 in men). Age‐specific IR by time period did not show significant changes over time. In a model adjusted for sex, race, and age group, the rate of AF did not change significantly from 1987 to 1991 compared with 2012 to 2017 (IR ratio, 1.10 [95% CI, 0.88–1.36] comparing 2012–2017 with 1987–1991). Similarly, no evidence of changes over time in AF rates were identified in men and women or White and Black participants separately. Even though IRs of AF increase as age increases, our analysis provided evidence suggesting that the overall IRs of AF have not changed over time in a multicenter cohort of Black and White individuals in the United States from 1987 to 2017.