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

Research output: Contribution to journalArticle

6 Citations (Scopus)

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

Keywords

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

ASJC Scopus subject areas

  • Epidemiology

Fingerprint Dive into the research topics of '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'. Together they form a unique fingerprint.

  • Cite this

    Ohsawa, M., Okamura, T., Tanno, K., Ogasawara, K., Itai, K., Yonekura, Y., Konishi, K., Omama, S., Miyamatsu, N., Turin, T. C., Morino, Y., Itoh, T., Onoda, T., Sakata, K., Ishibashi, Y., Makita, S., Nakamura, M., Tanaka, F., Kuribayashi, T., ... 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, 27(8), 360-367. https://doi.org/10.1016/j.je.2016.08.012