Thirty-Year Trends in the Incidence of Atrial Fibrillation: The Atherosclerosis Risk in Communities study Público

Abstract

Objective: To evaluate the 30-year trends in the incidence of atrial fibrillation (AF) in the Atherosclerosis Risk in Communities (ARIC) cohort and identify race and sex differences in these trends. 

Background: Long-term data to study recent trends in the incidence of AF, overall and across sex and race groups, are scarce. 

Methods: We included 15,343 men and women aged 45 to 64 in 1987-89 without AF from 4 US communities in the ARIC cohort. Incident AF was identified based on study electrocardiograms, hospital discharge codes, and death certificates through 2017. We calculated age and time period-specific incidence rates (IR) of AF. We used Poisson regression to calculate IR ratios of AF over time adjusting for age, sex and race. 

Results: A total of 3,241 AF cases were identified during a mean (SD) follow up of 22 (8.4) years (599 in African Americans, 2642 in whites, 1582 in women, 1659 in men). Overall, the IR of AF in the ARIC cohort was 9.6 per 1000 person-years (6.9 in African American, 10.5 in whites, 8.1 in women, and 11.6 in men). Age-specific IR by time-period did not show significant changes over time. In a model adjusted for sex, race, and age group, the rate of AF did not change from 1987- 1991 to 2012-2017 (IR ratio=1.10, 95% CI = 0.89-1.36 comparing 2012-2017 to 1987-1991). Similarly, no evidence of changes over time in AF rates were identified in men or women, whites or African Americans separately. 

Conclusions: Even though the incident rates of AF increase as age increases, our analysis provided evidence suggesting that the overall rates of AF have not changed over time in a multicenter cohort of African American and white individuals in the US from 1987 to 2017. 

Table of Contents

Background……………………………………………………………….….…11 

Methods……………………………………………………………….………...12 

Study population………………………………………………….………...12 

Outcome Ascertainment………………………………………….…….…13 

Other Variables………………………………………………………….......14 

Statistical Analysis……………………………………………………….....14 

Results……………………………………………..…………….…………….…15 

Discussion………………...…………………………….……………….………16 

Study strengths and limitations……………………………………….…18 

Conclusions…………………………………………….……………….………19 

References……………………………..……………………………..…………20 

Tables……………………………………………………….….………… ……..24 

Figure Legends………………………………………………………….…...…27 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Palabra Clave	incident rates atrial fibrillation trends whites African-Americans
Committee Chair / Thesis Advisor	Alonso, Alvaro, Emory University

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