Usefulness of Atrial Premature Complexes on Routine Electrocardiogram to Determine the Risk of Atrial Fibrillation (from the REGARDS Study)

• Type of Material: Article
• Authors: Wesley T. O'Neal, Emory University; Hooman Kamel, Cornell University; Suzanne E. Judd, University of Alabama Birmingham; Monika M. Safford, Cornell University; Viola Vaccarino, Emory University; Virginia J. Howard, University of Alabama; George Howard, University of Alabama; Elsayed Z. Soliman, Wake Forest School of Medicine
• Language: English
• Date: 2017-09-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 Elsevier Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.amjcard.2017.06.007
• Title of Journal or Parent Work: American Journal of Cardiology
• ISSN: 0002-9149
• Volume: 120
• Issue: 5
• Start Page: 782
• End Page: 785
• Grant/Funding Information: This research project is supported by a cooperative agreement U01NS041588 from the National Institute of Neurological Disorders and Stroke, and MMS received support from K24111154 from the National Heart Lung and Blood Institute, National Institutes of Health, Department of Health and Human Service.; WTO is supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number F32HL134290.; The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke or the National Institutes of Health.
• Keywords: Cardiovascular System & Cardiology; RACIAL-DIFFERENCES; PREVENTION; Life Sciences & Biomedicine; ASSOCIATION; WHITES; COHORT; PREVALENCE; OLDER-ADULTS; Cardiac & Cardiovascular Systems; EPIDEMIOLOGY; PATHOPHYSIOLOGY; Science & Technology; MANAGEMENT
• Research Categories: Biology, Biostatistics; Health Sciences, Epidemiology; Health Sciences, Medicine and Surgery

Abstract

Atrial premature complexes (APCs) serve as acute triggers for atrial fibrillation (AF), but it is currently unknown whether the association between APCs and AF varies by race or sex. We examined the association between APCs and AF in 13,840 (mean age = 63 ± 8.4 years; 56% women; 37% black) participants from the REasons for Geographic And Racial Differences in Stroke study. APCs were detected on baseline electrocardiograms (2003 to 2007). Incident AF was identified by study-scheduled electrocardiograms and self-reported history at a follow-up examination. Logistic regression was used to compute odds ratios (OR) and 95% confidence intervals for the association between APCs and incident AF. A total of 950 participants (6.9%) had APCs at the baseline visit. After a median follow-up of 9.4 years, 1015 incident AF cases (7.3%) were detected. APCs were associated with an increased risk of AF (odds ratios = 1.92, 95% confidence intervals = 1.57, 2.35). The relation between APCs and AF did not vary by race (interaction p value = 0.56) or sex (interaction p value = 0.66). In conclusion, APCs detected on a routine electrocardiogram are associated with an increased risk of AF development, and this association does not vary by race or sex. The findings of this analysis suggest that the risk of AF associated with atrial ectopy does not account for the differential risk of AF that is observed in whites compared with blacks, and in men compared with women.