TY - JOUR
T1 - Risk of stroke and heart failure attributable to atrial fibrillation in middle-aged and elderly people
T2 - Results from a five-year prospective cohort study of Japanese community dwellers
AU - Ohsawa, Masaki
AU - Okamura, Tomonori
AU - Tanno, Kozo
AU - Ogasawara, Kuniaki
AU - Itai, Kazuyoshi
AU - Yonekura, Yuki
AU - Konishi, Kazuki
AU - Omama, Shinichi
AU - Miyamatsu, Naomi
AU - Turin, Tanvir Chowdhury
AU - Morino, Yoshihiro
AU - Itoh, Tomonori
AU - Onoda, Toshiyuki
AU - Sakata, Kiyomi
AU - Ishibashi, Yasuhiro
AU - Makita, Shinji
AU - Nakamura, Motoyuki
AU - Tanaka, Fumitaka
AU - Kuribayashi, Toru
AU - Ohta, Mutsuko
AU - Okayama, Akira
N1 - Funding Information:
This study was supported by grants to Masaki Ohsawa (Grants-in-Aid for Scientific Research, Ippan C 21590660, Ippan B 24390155, and Ippan C 15K08745) from the Japan Society for the Promotion of Science; grants to Tomoaki Fujioka (H21-Jinshikkan-ippan-003), Akira Ogawa (H17-Choju-ippan-025 and H19-Choju-ippan-030), and Tomonori Okamura (Comprehensive Research on Cardiovascular and Life-Style Related Diseases: H23-Junkankitou [Seishuu]-Ippan-005 and Comprehensive Research on Cardiovascular and Life-Style Related Diseases: H26-Junkankitou [Seisaku]-Ippan-001) from the Japanese Ministry of Health, Labour and Welfare; and grants to Akira Okayama, Kuniaki Ogasawara, and Kazuyoshi Itai from the Japan Arteriosclerosis Prevention Fund. M.O. had full access to all data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis.
Publisher Copyright:
© 2017 The Authors.
PY - 2017
Y1 - 2017
N2 - Background: The relative and absolute risks of stroke and heart failure attributable to atrial fibrillation (AF) have not been sufficiently examined. Methods: A prospective study of 23,731 community-dwelling Japanese individuals was conducted. Participantswere divided into two groups based on the presence or absence of prevalent AF (n = 338 and n = 23,393, respectively). Excess events (EE) due to AF and relative risks (RRs) determined using the non-AF group as the reference for incident stroke and heart failurewere estimated using Poisson regression stratified by age groups (middle-aged: 40-69 years old; elderly: 70 years of age or older) after adjustment for sex and age. Results: There were 611 cases of stroke and 98 cases of heart failure during the observation period (131,088 person-years). AF contributed to a higher risk of stroke both in middle-aged individuals (EE 10.4 per 1000 person-years;RR4.88;95%confidenceinterval [CI],2.88-8.29) andelderlyindividuals (EE18.3per1000 personyears; RR 3.05; 95% CI, 2.05-4.54). AFalso contributed to a higher risk of heart failure in middle-aged individuals (EE 3.7 per 1000 person-years; RR 8.18; 95% CI, 2.41-27.8) and elderly individuals (EE 15.4 per 1000 personyears; RR 7.82; 95% CI, 4.11-14.9). Results obtained from multivariate-adjusted analysis were similar (stroke: EE 8.9 per 1000 person-years; RR 4.40; 95% CI, 2.57-7.55 inmiddle-aged and EE 17.4 per 1000 person-years; RR 2.97; 95% CI, 1.99-4.43 in elderly individuals; heart failure: EE 3.1 per 1000 person-years; RR 7.22; 95% CI, 2.06-25.3 in middle-aged and EE 14.1 per 1000 person-years; RR 7.41; 95% CI, 3.86-14.2 in elderly individuals). Conclusions: AF increased the risk of stroke by the same magnitude as that reported previously in Western countries. AF increased the RR of heart failure more than that in Western populations.
AB - Background: The relative and absolute risks of stroke and heart failure attributable to atrial fibrillation (AF) have not been sufficiently examined. Methods: A prospective study of 23,731 community-dwelling Japanese individuals was conducted. Participantswere divided into two groups based on the presence or absence of prevalent AF (n = 338 and n = 23,393, respectively). Excess events (EE) due to AF and relative risks (RRs) determined using the non-AF group as the reference for incident stroke and heart failurewere estimated using Poisson regression stratified by age groups (middle-aged: 40-69 years old; elderly: 70 years of age or older) after adjustment for sex and age. Results: There were 611 cases of stroke and 98 cases of heart failure during the observation period (131,088 person-years). AF contributed to a higher risk of stroke both in middle-aged individuals (EE 10.4 per 1000 person-years;RR4.88;95%confidenceinterval [CI],2.88-8.29) andelderlyindividuals (EE18.3per1000 personyears; RR 3.05; 95% CI, 2.05-4.54). AFalso contributed to a higher risk of heart failure in middle-aged individuals (EE 3.7 per 1000 person-years; RR 8.18; 95% CI, 2.41-27.8) and elderly individuals (EE 15.4 per 1000 personyears; RR 7.82; 95% CI, 4.11-14.9). Results obtained from multivariate-adjusted analysis were similar (stroke: EE 8.9 per 1000 person-years; RR 4.40; 95% CI, 2.57-7.55 inmiddle-aged and EE 17.4 per 1000 person-years; RR 2.97; 95% CI, 1.99-4.43 in elderly individuals; heart failure: EE 3.1 per 1000 person-years; RR 7.22; 95% CI, 2.06-25.3 in middle-aged and EE 14.1 per 1000 person-years; RR 7.41; 95% CI, 3.86-14.2 in elderly individuals). Conclusions: AF increased the risk of stroke by the same magnitude as that reported previously in Western countries. AF increased the RR of heart failure more than that in Western populations.
KW - Absolute risk
KW - Atrial fibrillation
KW - Heart failure
KW - Prospective study
KW - Relative risk
KW - Stroke
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U2 - 10.1016/j.je.2016.08.012
DO - 10.1016/j.je.2016.08.012
M3 - Article
C2 - 28390793
AN - SCOPUS:85026747306
SN - 0917-5040
VL - 27
SP - 360
EP - 367
JO - Journal of epidemiology
JF - Journal of epidemiology
IS - 8
ER -