Key result
African Americans show ~7% lower clinical AF prevalence than whites despite similar monitor-detected rates.
Why the study?
African Americans have a lower reported prevalence of clinically detected AF than whites despite more risk factors, prompting evaluation of whether ambulatory ECG monitoring reveals racial/ethnic differences.
Does the prevalence of clinically detected versus monitor-detected atrial fibrillation differ by race/ethnicity in a community-based cohort?
Population
1556 MESA cohort participants undergoing ambulatory ECG monitoring
Comparison
Clinically detected AF vs 14-day monitor-detected AF across racial/ethnic groups
Design
Cross-sectional analysis in a community-based cohort study
Follow-up
14.4 years
Authors
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Suggests under-detection drives lower clinical AF rates in African Americans; leaves open whether enhanced monitoring reduces disparities.
Cross-Sectional (n=1,556)
Yes
Does the prevalence of clinically detected versus monitor-detected atrial fibrillation differ by race/ethnicity in a community-based cohort?
Effect estimate: Adjusted rate difference -6.6% (95% CI -10.1% to -3.1%)
Absolute Event Rate: 6.6% vs 11.3%
p-value: p=<0.001
Ambulatory ECG monitoring reveals that the lower prevalence of clinically detected atrial fibrillation in African Americans compared to whites is likely due to differential clinical detection rather than a true difference in disease prevalence.
Heckbert et al. (2020) conducted a cross-sectional in Atrial Fibrillation (n=1,556). African American race/ethnicity vs. White race/ethnicity was evaluated on Prevalence of clinically detected atrial fibrillation (Adjusted rate difference -6.6%, 95% CI -10.1% to -3.1%, p=<0.001). African Americans had a lower prevalence of clinically detected AF than whites (adjusted rate difference -6.6%; 95% CI -10.1% to -3.1%; P<0.001), despite similar rates of monitor-detected AF.
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