This Article Figures Only Full Text Full Text (PDF) View Definition of Covariates All Versions of this Article: j.jacc.2006.10.062v1 49/9/986    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (13) Citing Articles via Google Scholar Google Scholar Articles by Miyasaka, Y. Articles by Tsang, T. S.M. Search for Related Content PubMed PubMed Citation Articles by Miyasaka, Y. Articles by Tsang, T. S.M.

CLINICAL RESEARCH: HEART RHYTHM DISORDER

Mortality Trends in Patients Diagnosed With First Atrial Fibrillation

A 21-Year Community-Based Study

Yoko Miyasaka, MD, PhD, FACC^_*, Marion E. Barnes, MSc^_*, Kent R. Bailey, PhD, Stephen S. Cha, MS, Bernard J. Gersh, MB, ChB, DPhil, FACC^_*, James B. Seward, MD, FACC^_* and Teresa S.M. Tsang, MD, FACC^_*,_*

^_* Division of Cardiovascular Disease and Internal Medicine, Mayo Clinic, Rochester, Minnesota.
Section of Biostatistics, Mayo Clinic, Rochester, Minnesota.

Manuscript received March 27, 2006; revised manuscript received October 19, 2006, accepted October 23, 2006.

^_* Reprint requests and correspondence: Dr. Teresa S. M. Tsang, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905. (Email: tsang.teresa{at}mayo.edu).

Objectives: The purpose of this study was to assess the mortality trends of atrial fibrillation (AF) in a community.

Background: Limited data exist regarding the mortality trends of patients diagnosed with first AF.

Methods: A community-based cohort of adult residents of Olmsted County, Minnesota, who had electrocardiogram-confirmed first-documented AF in the years 1980 to 2000 were identified and followed to 2004 or death. The primary outcome was all-cause mortality.

Results: Of a total of 4,618 residents (mean age 73 ± 14 years) diagnosed with first AF, 3,085 died during a mean follow-up of 5.3 ± 5.0 years. Relative to the age- and gender-matched general Minnesota population, the mortality risk was increased (p < 0.0001) with a hazard ratio (HR) of 9.62 (95% confidence interval [CI] 8.93 to 10.32) within the first 4 months and 1.66 (95% CI 1.59 to 1.73) thereafter. Cox proportional hazards modeling showed no change in overall age- and gender-adjusted mortality (HR for the year 2000 vs. 1980: 0.99; 95% CI 0.86 to 1.13; p = 0.84), even after adjustment for comorbidities. In secondary analyses, no changes in mortality were seen for early (within first 4 months) or late (after 4 months) mortality for the entire group or within the subgroup of patients who did not have cardiovascular disease at baseline.

Conclusions: In this cohort of patients newly diagnosed with AF, mortality risk was high, especially within the first 4 months. There was no evidence for any significant changes over the 21 years in terms of overall mortality, early or late mortality, or mortality among patients without pre-existing cardiovascular disease.

Abbreviations and Acronyms   AF = atrial fibrillation   CI = confidence interval   HR = hazard ratio

This article has been cited by other articles:

				J. Schmitt, G. Duray, B. J. Gersh, and S. H. Hohnloser Atrial fibrillation in acute myocardial infarction: a systematic review of the incidence, clinical features and prognostic implications Eur. Heart J., May 1, 2009; 30(9): 1038 - 1045. [Abstract] [Full Text] [PDF]

				WRITING GROUP MEMBERS, D. Lloyd-Jones, R. Adams, M. Carnethon, G. De Simone, T. B. Ferguson, K. Flegal, E. Ford, K. Furie, A. Go, et al. Heart Disease and Stroke Statistics--2009 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, January 27, 2009; 119(3): e21 - e181. [Full Text] [PDF]

				K. Wachtell, R. B. Devereux, P. A. Lyle, P. M. Okin, and E. Gerdts The left atrium, atrial fibrillation, and the risk of stroke in hypertensive patients with left ventricular hypertrophy Therapeutic Advances in Cardiovascular Disease, December 1, 2008; 2(6): 507 - 513. [Abstract] [PDF]

				J. S. Taggar, F. Marin, and G. Y.H. Lip Mortality in patients with atrial fibrillation: improving or not? Europace, April 1, 2008; 10(4): 389 - 390. [Full Text] [PDF]

				Writing Group Members, W. Rosamond, K. Flegal, K. Furie, A. Go, K. Greenlund, N. Haase, S. M. Hailpern, M. Ho, V. Howard, et al. Heart Disease and Stroke Statistics--2008 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, January 29, 2008; 117(4): e25 - e146. [Full Text] [PDF]

				H. M. Krumholz and F. A. Masoudi The Year in Epidemiology, Health Services Research, and Outcomes Research J. Am. Coll. Cardiol., December 4, 2007; 50(23): 2254 - 2262. [Full Text] [PDF]

				Other articles noted Evid. Based Med., August 1, 2007; 12(4): 127 - 128. [Full Text] [PDF]