Risk of stroke and heart failure attributable to atrial fibrillation in middle-aged and elderly people: Results from a five-year prospective cohort study of Japanese community dwellers

• Ohsawa Masaki

  Department of Internal Medicine, Iwate Medical University Department of Internal Medicine, Morioka Tsunagi Onsen Hospital

• Okamura Tomonori

  Department of Preventive Medicine and Public Health, Keio University

• Tanno Kozo

  Department of Hygiene and Preventive Medicine, Iwate Medical University

• Ogasawara Kuniaki

  Department of Neurosurgery, Iwate Medical University

• Itai Kazuyoshi

  Department of Nutritional Sciences, Morioka University

• Yonekura Yuki

  Department of Hygiene and Preventive Medicine, Iwate Medical University

• Konishi Kazuki

  Department of Internal Medicine, Morioka Tsunagi Onsen Hospital

• Omama Shinichi

  Department of Neurosurgery, Iwate Medical University

• Miyamatsu Naomi

  Department of Clinical Nursing, Shiga University of Medical Science

• Turin Tanvir Chowdhury

  Department of Community Health Sciences, University of Calgary

• Morino Yoshihiro

  Department of Internal Medicine, Iwate Medical University

• Itoh Tomonori

  Department of Internal Medicine, Iwate Medical University

• Onoda Toshiyuki

  Department of Hygiene and Preventive Medicine, Iwate Medical University

• Sakata Kiyomi

  Department of Hygiene and Preventive Medicine, Iwate Medical University

• Ishibashi Yasuhiro

  Department of Internal Medicine, Iwate Medical University

• Makita Shinji

  Department of Internal Medicine, Iwate Medical University

• Nakamura Motoyuki

  Department of Internal Medicine, Iwate Medical University

• Tanaka Fumitaka

  Department of Internal Medicine, Iwate Medical University

• Kuribayashi Toru

  Department of Health and Physical Education, Faculty of Education, Iwate University

• Ohta Mutsuko

  Iwate Health Service Association

• Okayama Akira

  The Research Institute of Strategy for Prevention

Abstract

Background: The relative and absolute risks of stroke and heart failure attributable to atrial fibrillation (AF) have not been sufficiently examined. Methods: A prospective study of 23,731 community-dwelling Japanese individuals was conducted. Participants were divided into two groups based on the presence or absence of prevalent AF (n = 338 and n = 23,393, respectively). Excess events (EE) due to AF and relative risks (RRs) determined using the non-AF group as the reference for incident stroke and heart failure were estimated using Poisson regression stratified by age groups (middle-aged: 40–69 years old; elderly: 70 years of age or older) after adjustment for sex and age. Results: There were 611 cases of stroke and 98 cases of heart failure during the observation period (131,088 person-years). AF contributed to a higher risk of stroke both in middle-aged individuals (EE 10.4 per 1000 person-years; RR 4.88; 95% confidence interval [CI], 2.88–8.29) and elderly individuals (EE 18.3 per 1000 person-years; RR 3.05; 95% CI, 2.05–4.54). AF also contributed to a higher risk of heart failure in middle-aged individuals (EE 3.7 per 1000 person-years; RR 8.18; 95% CI, 2.41–27.8) and elderly individuals (EE 15.4 per 1000 person-years; RR 7.82; 95% CI, 4.11–14.9). Results obtained from multivariate-adjusted analysis were similar (stroke: EE 8.9 per 1000 person-years; RR 4.40; 95% CI, 2.57–7.55 in middle-aged and EE 17.4 per 1000 person-years; RR 2.97; 95% CI, 1.99–4.43 in elderly individuals; heart failure: EE 3.1 per 1000 person-years; RR 7.22; 95% CI, 2.06–25.3 in middle-aged and EE 14.1 per 1000 person-years; RR 7.41; 95% CI, 3.86–14.2 in elderly individuals). Conclusions: AF increased the risk of stroke by the same magnitude as that reported previously in Western countries. AF increased the RR of heart failure more than that in Western populations.

Journal

• Journal of Epidemiology

  Journal of Epidemiology 27 (8), 360-367, 2017

  Japan Epidemiological Association

Keywords

• Atrial fibrillation
• Stroke
• Heart failure
• Prospective study
• Relative risk
• Absolute risk

Details

• CRID: 1390282679451620224
• NII Article ID: 130005906937
• DOI: 10.1016/j.je.2016.08.012
• ISSN: 13499092
• ISSN: 09175040
• Web Site: http://api.elsevier.com/content/article/PII:S0917504017300758?httpAccept=text/xml
• Web Site: http://api.elsevier.com/content/article/PII:S0917504017300758?httpAccept=text/plain
• Web Site: https://search.jamas.or.jp/link/ui/2018114758
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed