What is the clinical evidence from this study?

Study design: Cohort. Population: Atrial fibrillation (n=3922). Intervention: Atrial fibrillation vs. Sinus rhythm. Primary outcome: All-cause mortality (HR 1.87, 95% CI 1.09-3.20, p=0.02).

May 7, 2015Open Access

The prevalence, incidence, management and risks of atrial fibrillation in an elderly Chinese population: a prospective study

Key Result

Atrial fibrillation was associated with a significantly higher risk of all-cause mortality (HR 1.87) and cardiovascular mortality (HR 3.78) compared to sinus rhythm in an elderly Chinese population.

Study Design

Type

Cohort (n=3,922)

Multicenter

PICO

Population

Atrial fibrillation (n=3,922)

Intervention / Comparator

Atrial fibrillation vs Sinus rhythm

Primary Outcome

All-cause mortality — HR 1.87 (1.09-3.20), p=0.02

Main Result

Effect estimate: HR 1.87 (95% CI 1.09-3.20)

p-value: p=0.02

Limitations

Conducted in a single community, rendering results less representative than a multicenter study
Relatively small sample size and short follow-up
Did not perform echocardiography to accurately assess valvular heart disease and left ventricular dysfunction
Coronary artery disease was self-reported and might be underestimated
Ascertainment of atrial fibrillation was based on biennial rest ECGs only, which might lead to under-detection

Abstract

BACKGROUND: There is limited information on prevalent and incident atrial fibrillation in Chinese. We aimed to investigate the prevalence, incidence, management and risks of atrial fibrillation in an elderly Chinese population. METHODS: In a population--based prospective study in elderly (≥ 60 years) Chinese, we performed cardiovascular health examinations including a 12-lead electrocardiogram at baseline in 3,922 participants and biennially during follow-up in 2,017 participants. We collected information on vital status during the whole follow-up period. RESULTS: The baseline prevalence of atrial fibrillation was 2.0 % (n = 34) in 1718 men and 1.6 % (n = 36) in 2204 women. During a median 3.8 years of follow-up, the incidence rate of atrial fibrillation (n = 34) was 4.9 per 1000 person-years (95 % confidence interval CI, 3.4-6.9). In univariate analysis, both the prevalence and incidence of atrial fibrillation were higher with age advancing (P < 0.0001) and in the presence of coronary heart disease (P ≤ 0.02). Of the 104 prevalent and incident cases of atrial fibrillation, only 1 (1.0 %) received anticoagulant therapy (warfarin). These patients with atrial fibrillation, compared with those with sinus rhythm, had significantly higher risks of all-cause (n = 261, hazard ratio HR 1.87, 95 % CI, 1.09-3.20, P = 0.02), cardiovascular (n = 136, HR 3.78, 95 % CI 2.17-6.58, P < 0.0001) and stroke mortality (n = 44, HR 6.31, 95 % CI 2.81-14.19, P = 0.0003). CONCLUSIONS: Atrial fibrillation was relatively frequent in elderly Chinese, poorly managed and associated with higher risks of mortality.

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Cite This Study

Li et al. (Thu,) conducted a cohort in Atrial fibrillation (n=3,922). Atrial fibrillation vs. Sinus rhythm was evaluated on All-cause mortality (HR 1.87, 95% CI 1.09-3.20, p=0.02). Atrial fibrillation was associated with a significantly higher risk of all-cause mortality (HR 1.87) and cardiovascular mortality (HR 3.78) compared to sinus rhythm in an elderly Chinese population.

synapsesocial.com/papers/6a158a645347fbb1739ff06e https://doi.org/https://doi.org/10.1186/s12872-015-0023-3

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