Relative and absolute risks of all-cause and cause-specific deaths attributable to atrial fibrillation in middle-aged and elderly community dwellers

Masaki Ohsawa, Tomonori Okamura, Kuniaki Ogasawara, Akira Ogawa, Tomoaki Fujioka, Kozo Tanno, Yuki Yonekura, Shinichi Omama, Tanvir Chowdhury Turin, Kazuyoshi Itai, Yasuhiro Ishibashi, Yoshihiro Morino, Tomonori Itoh, Naomi Miyamatsu, Toshiyuki Onoda, Toru Kuribayashi, Shinji Makita, Yuki Yoshida, Motoyuki Nakamura, Fumitaka TanakaMutsuko Ohta, Kiyomi Sakata, Akira Okayama

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: The relative and absolute risks of outcomes other than all-cause death (ACD) attributable to atrial fibrillation (AF) stratified age have not been sufficiently investigated. Methods: A prospective study of 23,634 community dwellers aged 40 years or older without organic cardiovascular disease (AF = 335, non-AF = 23,299) was conducted. Multivariate-adjusted rates, rate ratios (RRs) and excess deaths (EDs) for ACD, cardiovascular death (CVD) and non-cardiovascular death (non-CVD), and sexand age-adjusted RR and ED in middle-aged (40 to 69) and elderly (70 years or older) for ACD, CVD, non-CVD, sudden cardiac death (SCD), stroke-related death (Str-D), neoplasm-related death (NPD), and infectionrelated death (IFD) attributable to AF were estimated using Poisson regression. Results: Multivariate-adjusted analysis revealed that AF significantly increased the risk of ACD (RR [95% confidence interval]:1.70 [1.23-2.95]) and CVD (3.86 [2.38-6.27]), but not non-CVD. Age-stratified analysis revealed that AF increased the risk of Str-D in middle-aged (14.5 [4.77-44.3]) and elderly individuals (4.92 [1.91-12.7]), SCD in elderly individuals (3.21 [1.37-7.51]), and might increase the risk of IFD in elderly individuals (2.02 [0.80-4.65], p = 0.098). The RR of CVD was higher in middle-aged versus elderly individuals (RRs, 6.19 vs. 3.57) but the absolute risk difference was larger in elderly individuals (EDs: 7.6 vs. 3.0 per 1000 person-years). Conclusions: Larger absolute risk differences for ACD and CVD attributable to AF among elderly people indicate that the absolute burden of AF is higher in elderly versus middle-aged people despite the relatively small RR.

Original languageEnglish
Pages (from-to)692-698
Number of pages7
JournalInternational Journal of Cardiology
Volume184
Issue number1
DOIs
Publication statusPublished - 2015

Keywords

  • Absolute risk difference
  • Atrial fibrillation
  • Cardiovascular death
  • Non-cardiovascular death
  • Relative risk
  • Sudden cardiac death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Ohsawa, M., Okamura, T., Ogasawara, K., Ogawa, A., Fujioka, T., Tanno, K., Yonekura, Y., Omama, S., Turin, T. C., Itai, K., Ishibashi, Y., Morino, Y., Itoh, T., Miyamatsu, N., Onoda, T., Kuribayashi, T., Makita, S., Yoshida, Y., Nakamura, M., ... Okayama, A. (2015). Relative and absolute risks of all-cause and cause-specific deaths attributable to atrial fibrillation in middle-aged and elderly community dwellers. International Journal of Cardiology, 184(1), 692-698. https://doi.org/10.1016/j.ijcard.2015.03.068