Age-specific atrial fibrillation incidence, attributable risk factors and risk of stroke and mortality: results from the MORGAM Consortium.

Autor:	Morseth B; School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway bente.morseth@uit.no., Geelhoed B; Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany., Linneberg A; Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Johansson L; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden., Kuulasmaa K; Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland., Salomaa V; Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland., Iacoviello L; Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy.; Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy., Costanzo S; Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy., Söderberg S; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden., Niiranen TJ; Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland.; Department of Medicine, Turku University Hospital and University of Turku, Turku, Finland., Vishram-Nielsen JKK; Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark.; Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Njølstad I; Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway., Wilsgaard T; Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway., Mathiesen EB; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.; Department of Neurology, University Hospital of North Norway, Tromsø, Norway., Løchen ML; Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway., Zeller T; Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany., Blankenberg S; Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany., Ojeda FM; Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany., Schnabel RB; Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany.
Jazyk:	angličtina
Zdroj:	Open heart [Open Heart] 2021 Jul; Vol. 8 (2).
DOI:	10.1136/openhrt-2021-001624
Abstrakt:	Background: The main aim was to examine age-specific risk factor associations with incident atrial fibrillation (AF) and their attributable fraction in a large European cohort. Additionally, we aimed to examine risk of stroke and mortality in relation to new-onset AF across age. Methods: We used individual-level data (n=66 951, 49.1% men, age range 40-98 years at baseline) from five European cohorts of the MOnica Risk, Genetics, Archiving and Monograph Consortium. The participants were followed for incident AF for up to 10 years and the association with modifiable risk factors from the baseline examinations (body mass index (BMI), hypertension, diabetes, daily smoking, alcohol consumption and history of stroke and myocardial infarction (MI)) was examined. Additionally, the participants were followed up for incident stroke and all-cause mortality after new-onset AF. Results: AF incidence increased from 0.9 per 1000 person-years at baseline age 40-49 years, to 17.7 at baseline age ≥70 years. Multivariable-adjusted Cox models showed that higher BMI, hypertension, high alcohol consumption and a history of stroke or MI were associated with increased risk of AF across age groups (p<0.05). Between 30% and 40% of the AF risk could be attributed to BMI, hypertension and a history of stroke or MI. New-onset AF was associated with a twofold increase in risk of stroke and death at ages≥70 years (p≤0.001). Conclusion: In this large European cohort aged 40 years and above, risk of AF was largely attributed to BMI, high alcohol consumption and a history MI or stroke from middle age. Thus, preventive measures for AF should target risk factors such as obesity and hypertension from early age and continue throughout life. Competing Interests: Competing interests: RBS has received lecture fees and advisory board fees from BMS/Pfizer outside this work. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu