Incidence of Atrial Fibrillation and Relationship With Cardiovascular Events, Heart Failure, and Mortality A Community-Based Study From the Netherlands

Rob A. Vermond, Bastiaan Geelhoed, Niek Verweij, Robert G. Tieleman, Pim Van der Harst, Hans L. Hillege, Wiek H. van Gilst, Isabelle C. Van Gelder, Michiel Rienstra*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

217 Citations (Scopus)
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Abstract

BACKGROUND Important improvements have been made in treatment of diseases associated with atrial fibrillation (AF), such as hypertension, myocardial infarction, and heart failure. Incidence rates and risk factors may have changed with the aging of the population and changing lifestyles. Currently, the risk for AF is only partially explained, possibly because of differences between older cohorts and contemporary populations.

OBJECTIVES This study investigated the incidence of AF in a contemporary cohort in the Netherlands, together with comorbidities associated with AF and associations of AF with cardiovascular outcomes.

METHODS Incident AF was ascertained for hospital and study electrocardiograms in 8,265 participants of the PREVEND (Prevention of Renal and Vascular End-Stage Disease) study in Groningen, the Netherlands.

RESULTS During 9.7 +/- 2.3 years of follow-up, 265 participants developed AF, with a resulting overall AF incidence of 3.3 per 1,000 person-years. Advancing age, male sex, antihypertensive drug use, higher body mass index, previous myocardial infarction, and previous stroke were associated with AF. After multivariable adjustment, AF was associated with cardiovascular events (hazard ratio [HR]: 2.24; 95% confidence interval [CI]: 1.06 to 4.75; p = 0.035), heart failure with either reduced or preserved ejection fraction (HR: 4.52; 95% CI: 2.02 to 10.09; p <0.001), and all-cause mortality (HR: 3.02; 95% CI: 1.73 to 5.27; p <0.001).

CONCLUSIONS The incidence of AF in the present cohort was comparable to that shown in data of older studies. Obesity has become a major risk factor for incident AF. Although overall cardiovascular event rates were lower in the present study, the present study confirms the association of incident AF with such events. (C) 2015 by the American College of Cardiology Foundation.

Original languageEnglish
Pages (from-to)1000-1007
Number of pages8
JournalJournal of the American College of Cardiology
Volume66
Issue number9
DOIs
Publication statusPublished - 1-Sept-2015

Keywords

  • atrial fibrillation
  • comorbidities
  • epidemiology
  • heart failure
  • mortality
  • outcome
  • ASSOCIATION CONSENSUS CONFERENCE
  • RISK-FACTORS
  • GENERAL-POPULATION
  • OLDER-ADULTS
  • PREVALENCE
  • COHORT
  • PROJECTIONS
  • WARFARIN
  • INDIVIDUALS
  • MANAGEMENT

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