Atrial fibrillation incidence and risk factors in relation to race-ethnicity and the population attributable fraction of atrial fibrillation risk factors: the Multi-Ethnic Study of Atherosclerosis.
Atrial fibrillation incidence and risk factors in relation to race-ethnicity and the population attributable fraction of atrial fibrillation risk factors: the Multi-Ethnic Study of Atherosclerosis.
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DOI：
10.1016/j.annepidem.2014.11.024
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发表时间：
2015-02
影响因子：
5.6
通讯作者：
Heckbert SR
中科院分区：
文献类型：
--
作者：
Rodriguez CJ;Soliman EZ;Alonso A;Swett K;Okin PM;Goff DC Jr;Heckbert SR
我们在基于社区的前瞻性动脉粥样硬化多种族研究 (MESA) 中研究了突发心房颤动 (AF)。据报道，与非西班牙裔白人 (NHW) 相比，非西班牙裔黑人 (NHB) 的房颤负担较低。关于西班牙裔和亚洲人群中房颤流行病学的信息要有限得多。我们排除了入组时有房颤病史的参与者。根据出院国际疾病分类第九修订版代码确定的首次 AF 事件，共有 6721 名 MESA 参与者接受了监测。根据每 1000 人年的观察计算年龄和性别调整后的 AF 发病率 (IR)。使用 NHW 作为参考组计算 IR 比率。确定了已确定的可改变的房颤危险因素的年龄和性别调整后的人群归因分数（PAF）。在 MESA 队列中，47.2% 为男性；基线时，25.7% 患有高血压； 12.5%患有糖尿病。平均随访 7.3 年期间发生了 305 起住院房颤事件。年龄和性别调整后的 IR 和 IR 比率显示，与 NHW 相比，西班牙裔、NHB 和中国人的总体 AF 发生率显着较低（所有 P < .001）。在 65 岁或以上的参与者中，西班牙裔、华人和黑人的 AF 发生率显着低于 NHW（所有 P ≥ 01），但 65 岁以下参与者的 IR 相似。 NHB 中吸烟的 PAF 为 27%，但其他种族群体中则较低。在 NHW 中，高血压的 PAF 为 22.2%，但在 NHB（33.1%）、华人（46.3%）和西班牙裔（43.9%）中这一比例更高。总体而言，西班牙裔、NHB 和中国人的住院 AF 发生率显着低于 NHW。与 NHW 相比，非白人人群中更大比例的 AF 事件似乎可归因于高血压。
We studied incident atrial fibrillation (AF) in the prospective community-based Multi-Ethnic Study of Atherosclerosis (MESA). Reportedly, non-Hispanic blacks (NHBs) have a lower AF burden compared with their non-Hispanic white (NHW) counterparts. Information on the epidemiology of AF in Hispanic and Asian populations is much more limited. We excluded participants with a history of AF at enrollment. A total of 6721 MESA participants were monitored for the first AF event ascertained according to hospital discharge International Classification of Diseases, Ninth Revision, codes. Age- and sex-adjusted incidence rates (IRs) of AF were calculated per 1000 person-years of observation. IR ratios were calculated using NHWs as the reference group. Age- and sex-adjusted population attributable fractions (PAFs) of established modifiable AF risk factors were ascertained. In the MESA cohort, 47.2% was male; at baseline, 25.7% had hypertension; 12.5% had diabetes. Three hundred five incident hospitalized AF events occurred over a mean follow-up of 7.3 years. Age- and sex-adjusted IRs and IR ratios showed that overall AF incidence was significantly lower among Hispanics, NHBs and Chinese compared with NHWs (all P < .001). Among participants 65 years of age or greater, Hispanics, Chinese, and blacks had significantly lower AF incidence than NHWs (all P ≥ 01), but IRs were similar among participants under age 65 years. The PAF for smoking was 27% among NHBs but lower among other race–ethnic groups. Among NHWs, the PAF for hypertension was 22.2%, but this was higher among NHBs (33.1%), Chinese (46.3%), and Hispanics (43.9%). Overall, the incidence of hospitalized AF was significantly lower in Hispanics, NHBs, and Chinese than in NHWs. A larger proportion of AF events appear to be attributable to hypertension among nonwhite populations compared with NHWs.