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July 5, 2017JAMA CardiologyOpen Access

Association of a Family History of Atrial Fibrillation With Incidence and Outcomes of Atrial Fibrillation

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Why the study?

Does a family history of atrial fibrillation increase the risk of incident AF and affect MACE-free survival in the general population?

Population

23,422,955 individuals registered in the Taiwan National Health Insurance Research Database in 2013, of whom…

Comparison

Family history of atrial fibrillation vs No family history of atrial fibrillation

Design

Cohort

Authors

SCShang‐Hung ChangElectrophysiologyCKChang‐Fu KuoCross-Cutting CardiologyICI‐Jun ChouChang Gung Memorial Hospital

Discussion

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Overview

Family history may help identify patients at risk for incident AF but lacks prognostic utility for subsequent cardiovascular events.

Structured PICO

Does a family history of atrial fibrillation increase the risk of incident AF and affect MACE-free survival in the general population?

P
Population
23,422,955 individuals registered in the Taiwan National Health Insurance Research Database in 2013, of whom 177,770 had a diagnosis of atrial fibrillation. A subgroup of 1,510 patients (mean age 57.9, 13.5% female) with newly diagnosed AF and a first-degree relative affected by AF was matched 1:4 to controls.
I
Intervention
Family history of atrial fibrillation (having a first-degree relative affected by AF)
C
Comparator
No family history of atrial fibrillation (matched 1:4 for age, sex, hypertension, type 2 diabetes, previous stroke, and anticoagulation)
O
Outcome
Prevalence and relative risk of AF in relatives, relative contributions of heritability and shared and nonshared environmental factors to AF susceptibility, and MACE-free survival after AF diagnosiscomposite

A family history of atrial fibrillation nearly doubles the risk of developing the condition but does not worsen subsequent cardiovascular outcomes, suggesting it has limited prognostic utility for MACE.

Cite This Study

Chang et al. (2017) studied this question.

synapsesocial.com/papers/6a7c2770c2a640f0bcdf98aahttps://doi.org/10.1001/jamacardio.2017.1855
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Acute Kidney Injury in Asians With Atrial Fibrillation Treated With Dabigatran or Warfarin2016 · 76 citations
  2. 2Family history of atrial fibrillation is associated with earlier-onset and more symptomatic atrial fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry2016 · 27 citations
  3. 3Familial clustering and subsequent incidence of atrial fibrillation among first-degree relatives in Denmark2015 · 18 citations
  4. 4Association Between Familial Atrial Fibrillation and Risk of New-Onset Atrial Fibrillation2010 · 313 citations
  5. 5High Familial Risk of Atrial Fibrillation/Atrial Flutter in Multiplex Families: A Nationwide Family Study in Sweden2013 · 42 citations