Atrial fibrillation prevalence, incidence and risk of stroke and all-cause death among Chinese☆
Introduction
Atrial fibrillation (AF) is associated with congestive heart failure and thromboembolic mortality and morbidity, and is highly prevalent among the elderly population [1], [2], [3]. The substantial clinical impact and potential curable disease of AF have made it mandatory for health professionals to understand the prevalence, incidence and associated factors of AF risk [1], [4]. Although AF data on the Caucasian and African-American populations are available [5], [6], less is known about Asians and other ethnicities, especially from the community-based general population [7], [8]. In addition, various risk factors associated with AF are also related to cardiovascular events and all-cause death in the general population and in specific clinical settings [9], such as older age, poor left ventricular function and hypertension [2], [10]. Previous studies, based on cohort follow-ups in the general population or hospital setting [11], [12], have demonstrated that AF was a significant predictor for stroke and all-cause death. In addition, AF as a predictor for stroke and all-cause death in the Chinese general population is still unknown. Therefore, we investigated the AF risk based on the Chin-Shan Community Cardiovascular Cohort (CCCC) study, which provided a unique opportunity to explore the new-onset AF using its serial follow-up and complete biochemical and anthropometric measurements of the adult participants living in the community.
Section snippets
Study design and study participants
Full details of the CCCC study can be found in other publications [13], [14], [15], [16]. Briefly, the CCCC Study began in 1990 by recruiting 1703 men and 1899 women ≥ 35 years old, homogeneous in Chinese ethnicity, and living in the Chin-Shan township 30 km north of metropolitan Taipei, Taiwan. Information about anthropometry, lifestyle, and medical conditions was assessed by interview questionnaires in two-year cycles, and the validity and reproducibility of the collected data and measurements
Results
Of the 3560 participants with available electrographic data at baseline, 38 had established AF rhythm. Table 1 shows the baseline characteristics of study participants specified by prevalent AF status. Participants with prevalent AF were more likely to be male, of older age, white collar or no job status, and smokers, and more likely to have hypertension, diabetes and poor left ventricular ejection fraction than those without prevalent AF. The lifestyle factors, including alcohol intake and
Discussion
In this prospective cohort of middle-aged to older ethnic Chinese, we clearly demonstrated AF as a significant predictor for stroke and all-cause death, after extensive adjustments. AF was also highly prevalent and incident among elderly Chinese adults.
Our findings are consistent with other population-based studies on the prevalence and incidence of AF risk [7], [27]. With regards to the prevalence rates, our data were consistent with a cross-sectional survey data in the US [5] wherein the AF
Acknowledgements
The authors thank the staff of the Department of Internal Medicine, National Taiwan University Hospital, and the participants of the CCCC study for their valuable contributions. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology [47].
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This study was partially supported by the National Science Council (grant number: NSC 96-2314-B-002-155).