Mortality Trends in Patients Diagnosed With First Atrial Fibrillation. A 21-Year Community-Based Study

Yoko Miyasaka, Marion E. Barnes, Kent R Bailey, Stephen S. Cha, Bernard J. Gersh, James B. Seward, Teresa S M Tsang

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)986-992
Number of pages7
JournalJournal of the American College of Cardiology
Volume49
Issue number9
DOIs
StatePublished - Mar 6 2007

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Atrial Fibrillation
Mortality
Confidence Intervals
Cardiovascular Diseases
Preexisting Condition Coverage
Comorbidity
Electrocardiography

ASJC Scopus subject areas

  • Nursing(all)

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Mortality Trends in Patients Diagnosed With First Atrial Fibrillation. A 21-Year Community-Based Study. / Miyasaka, Yoko; Barnes, Marion E.; Bailey, Kent R; Cha, Stephen S.; Gersh, Bernard J.; Seward, James B.; Tsang, Teresa S M.

In: Journal of the American College of Cardiology, Vol. 49, No. 9, 06.03.2007, p. 986-992.

Research output: Contribution to journalArticle

Miyasaka, Yoko ; Barnes, Marion E. ; Bailey, Kent R ; Cha, Stephen S. ; Gersh, Bernard J. ; Seward, James B. ; Tsang, Teresa S M. / Mortality Trends in Patients Diagnosed With First Atrial Fibrillation. A 21-Year Community-Based Study. In: Journal of the American College of Cardiology. 2007 ; Vol. 49, No. 9. pp. 986-992.
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abstract = "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.",
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