HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Atrial fibrillation and the risk of myocardial infarction.

AbstractIMPORTANCE:
Myocardial infarction (MI) is an established risk factor for atrial fibrillation (AF). However, the extent to which AF is a risk factor for MI has not been investigated.
OBJECTIVE:
To examine the risk of incident MI associated with AF.
DESIGN, SETTING, AND PARTICIPANTS:
A prospective cohort of 23,928 participants residing in the continental United States and without coronary heart disease at baseline were enrolled from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort between 2003 and 2007, with follow-up through December 2009.
MAIN OUTCOMES AND MEASURES:
Expert-adjudicated total MI events (fatal and nonfatal).
RESULTS:
Over 6.9 years of follow-up (median 4.5 years), 648 incident MI events occurred. In a sociodemographic-adjusted model, AF was associated with about 2-fold increased risk of MI (hazard ratio [HR], 1.96 [95% CI, 1.52-2.52]). This association remained significant (HR, 1.70 [95% CI, 1.26-2.30]) after further adjustment for total cholesterol, high-density lipoprotein cholesterol, smoking status, systolic blood pressure, blood pressure-lowering drugs, body mass index, diabetes, warfarin use, aspirin use, statin use, history of stroke and vascular disease, estimated glomerular filtration rate, albumin to creatinine ratio, and C-reactive protein level. In subgroup analysis, the risk of MI associated with AF was significantly higher in women (HR, 2.16 [95% CI, 1.41-3.31]) than in men (HR, 1.39 [95% CI, 0.91-2.10]) and in blacks (HR, 2.53 [95% CI, 1.67-3.86]) than in whites (HR, 1.26 [95% CI, 0.83-1.93]); for interactions, P = .03 and P = .02, respectively. On the other hand, there were no significant differences in the risk of MI associated with AF in older (≥75 years) vs younger (<75 years) participants (HR, 2.00 [95% CI, 1.16-3.35] and HR, 1.60 [95% CI, 1.11-2.30], respectively); for interaction, P = .44.
CONCLUSIONS AND RELEVANCE:
AF is independently associated with an increased risk of incident MI, especially in women and blacks. These findings add to the growing concerns of the seriousness of AF as a public health burden: in addition to being a well-known risk factor for stroke, AF is also associated with increased risk of MI.
AuthorsElsayed Z Soliman, Monika M Safford, Paul Muntner, Yulia Khodneva, Farah Z Dawood, Neil A Zakai, Evan L Thacker, Suzanne Judd, Virginia J Howard, George Howard, David M Herrington, Mary Cushman
JournalJAMA internal medicine (JAMA Intern Med) Vol. 174 Issue 1 Pg. 107-14 (Jan 2014) ISSN: 2168-6114 [Electronic] United States
PMID24190540 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
Topics
  • Black or African American (statistics & numerical data)
  • Aged
  • Atrial Fibrillation (epidemiology, ethnology)
  • Cohort Studies
  • Diabetes Mellitus (epidemiology)
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension (epidemiology)
  • Male
  • Middle Aged
  • Myocardial Infarction (epidemiology, ethnology)
  • Proportional Hazards Models
  • Prospective Studies
  • Renal Insufficiency, Chronic (epidemiology)
  • Risk Factors
  • Sex Factors
  • United States (epidemiology)
  • White People (statistics & numerical data)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: