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

Masaki Ohsawa, Tomonori Okamura, Kozo Tanno, Kuniaki Ogasawara, Kazuyoshi Itai, Yuki Yonekura, Kazuki Konishi, Shinichi Omama, Naomi Miyamatsu, Tanvir Chowdhury Turin, Yoshihiro Morino, Tomonori Itoh, Toshiyuki Onoda, Kiyomi Sakata, Yasuhiro Ishibashi, Shinji Makita, Motoyuki Nakamura, Fumitaka Tanaka, Toru Kuribayashi, Mutsuko OhtaAkira Okayama

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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. Participantswere 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 failurewere 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;RR4.88;95%confidenceinterval [CI],2.88-8.29) andelderlyindividuals (EE18.3per1000 personyears; RR 3.05; 95% CI, 2.05-4.54). AFalso 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 personyears; 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 inmiddle-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.

Original languageEnglish
Pages (from-to)360-367
Number of pages8
JournalJournal of Epidemiology
Volume27
Issue number8
DOIs
Publication statusPublished - 2017

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Atrial Fibrillation
Cohort Studies
Heart Failure
Stroke
Prospective Studies
Independent Living
Multivariate Analysis
Age Groups
Observation

Keywords

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

ASJC Scopus subject areas

  • Epidemiology

Cite this

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; Okamura, Tomonori; Tanno, Kozo; Ogasawara, Kuniaki; Itai, Kazuyoshi; Yonekura, Yuki; Konishi, Kazuki; Omama, Shinichi; Miyamatsu, Naomi; Turin, Tanvir Chowdhury; Morino, Yoshihiro; Itoh, Tomonori; Onoda, Toshiyuki; Sakata, Kiyomi; Ishibashi, Yasuhiro; Makita, Shinji; Nakamura, Motoyuki; Tanaka, Fumitaka; Kuribayashi, Toru; Ohta, Mutsuko; Okayama, Akira.

In: Journal of Epidemiology, Vol. 27, No. 8, 2017, p. 360-367.

Research output: Contribution to journalArticle

Ohsawa, M, Okamura, T, Tanno, K, Ogasawara, K, Itai, K, Yonekura, Y, Konishi, K, Omama, S, Miyamatsu, N, Turin, TC, Morino, Y, Itoh, T, Onoda, T, Sakata, K, Ishibashi, Y, Makita, S, Nakamura, M, Tanaka, F, Kuribayashi, T, Ohta, M & Okayama, A 2017, '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', Journal of Epidemiology, vol. 27, no. 8, pp. 360-367. https://doi.org/10.1016/j.je.2016.08.012
Ohsawa, Masaki ; Okamura, Tomonori ; Tanno, Kozo ; Ogasawara, Kuniaki ; Itai, Kazuyoshi ; Yonekura, Yuki ; Konishi, Kazuki ; Omama, Shinichi ; Miyamatsu, Naomi ; Turin, Tanvir Chowdhury ; Morino, Yoshihiro ; Itoh, Tomonori ; Onoda, Toshiyuki ; Sakata, Kiyomi ; Ishibashi, Yasuhiro ; Makita, Shinji ; Nakamura, Motoyuki ; Tanaka, Fumitaka ; Kuribayashi, Toru ; Ohta, Mutsuko ; Okayama, Akira. / 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. In: Journal of Epidemiology. 2017 ; Vol. 27, No. 8. pp. 360-367.
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title = "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",
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. Participantswere 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 failurewere 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;RR4.88;95{\%}confidenceinterval [CI],2.88-8.29) andelderlyindividuals (EE18.3per1000 personyears; RR 3.05; 95{\%} CI, 2.05-4.54). AFalso 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 personyears; 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 inmiddle-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.",
keywords = "Absolute risk, Atrial fibrillation, Heart failure, Prospective study, Relative risk, Stroke",
author = "Masaki Ohsawa and Tomonori Okamura and Kozo Tanno and Kuniaki Ogasawara and Kazuyoshi Itai and Yuki Yonekura and Kazuki Konishi and Shinichi Omama and Naomi Miyamatsu and Turin, {Tanvir Chowdhury} and Yoshihiro Morino and Tomonori Itoh and Toshiyuki Onoda and Kiyomi Sakata and Yasuhiro Ishibashi and Shinji Makita and Motoyuki Nakamura and Fumitaka Tanaka and Toru Kuribayashi and Mutsuko Ohta and Akira Okayama",
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TY - JOUR

T1 - Risk of stroke and heart failure attributable to atrial fibrillation in middle-aged and elderly people

T2 - Results from a five-year prospective cohort study of Japanese community dwellers

AU - Ohsawa, Masaki

AU - Okamura, Tomonori

AU - Tanno, Kozo

AU - Ogasawara, Kuniaki

AU - Itai, Kazuyoshi

AU - Yonekura, Yuki

AU - Konishi, Kazuki

AU - Omama, Shinichi

AU - Miyamatsu, Naomi

AU - Turin, Tanvir Chowdhury

AU - Morino, Yoshihiro

AU - Itoh, Tomonori

AU - Onoda, Toshiyuki

AU - Sakata, Kiyomi

AU - Ishibashi, Yasuhiro

AU - Makita, Shinji

AU - Nakamura, Motoyuki

AU - Tanaka, Fumitaka

AU - Kuribayashi, Toru

AU - Ohta, Mutsuko

AU - Okayama, Akira

PY - 2017

Y1 - 2017

N2 - 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. Participantswere 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 failurewere 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;RR4.88;95%confidenceinterval [CI],2.88-8.29) andelderlyindividuals (EE18.3per1000 personyears; RR 3.05; 95% CI, 2.05-4.54). AFalso 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 personyears; 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 inmiddle-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.

AB - 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. Participantswere 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 failurewere 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;RR4.88;95%confidenceinterval [CI],2.88-8.29) andelderlyindividuals (EE18.3per1000 personyears; RR 3.05; 95% CI, 2.05-4.54). AFalso 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 personyears; 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 inmiddle-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.

KW - Absolute risk

KW - Atrial fibrillation

KW - Heart failure

KW - Prospective study

KW - Relative risk

KW - Stroke

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