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Ethnic differences in atrial fibrillation among patients with heart failure in Asia
AIMS: We aimed to characterize ethnic differences in prevalence, clinical correlates, and outcomes of atrial fibrillation (AF) in heart failure (HF) with preserved and reduced ejection fraction (HFpEF and HFrEF) across Asia. METHODS AND RESULTS: Among 5504 patients with HF prospectively recruited ac...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373934/ https://www.ncbi.nlm.nih.gov/pubmed/32383559 http://dx.doi.org/10.1002/ehf2.12696 |
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author | Tan, Eugene S.J. Goh, Vera Santema, Bernadet T. Tay, Wan Ting Teng, Tiew‐Hwa Katherine Yap, Jonathan Tromp, Jasper Hung, Chung‐Lieh Chopra, Vijay Anand, Inder MacDonald, Michael R. Ling, Lieng Hsi Van Gelder, Isabelle C. Rienstra, Michiel Voors, Adriaan A. Richards, A. Mark Lam, Carolyn S.P. |
author_facet | Tan, Eugene S.J. Goh, Vera Santema, Bernadet T. Tay, Wan Ting Teng, Tiew‐Hwa Katherine Yap, Jonathan Tromp, Jasper Hung, Chung‐Lieh Chopra, Vijay Anand, Inder MacDonald, Michael R. Ling, Lieng Hsi Van Gelder, Isabelle C. Rienstra, Michiel Voors, Adriaan A. Richards, A. Mark Lam, Carolyn S.P. |
author_sort | Tan, Eugene S.J. |
collection | PubMed |
description | AIMS: We aimed to characterize ethnic differences in prevalence, clinical correlates, and outcomes of atrial fibrillation (AF) in heart failure (HF) with preserved and reduced ejection fraction (HFpEF and HFrEF) across Asia. METHODS AND RESULTS: Among 5504 patients with HF prospectively recruited across 11 Asian regions using identical protocols in the Asian Sudden Cardiac Death in Heart Failure study (mean age 61 ± 13 years, 27% women, 83% HFrEF), 1383 (25%) had AF defined as a history of AF and/or AF/flutter on baseline electrocardiogram. Clinical correlates of AF were similar across ethnicities and included older age, prior stroke, higher NT‐proBNP, and larger left atria. Diabetes was associated with lower odds of AF in HFrEF [adjusted odds ratio (AOR) 0.79, 95% CI 0.66–0.95] and HFpEF (AOR 0.58, 95% CI 0.39–0.84) regardless of ethnicity. Compared with Chinese ethnicity, Japanese/Koreans had higher odds of AF in HFrEF (AOR 1.76, 95% CI 1.40–2.21), while Indians had lower odds in HFrEF (AOR 0.18, 95% CI 0.13–0.24) and HFpEF (AOR 0.28, 95% CI 0.16–0.49) even after adjusting for clinical covariates. Interaction between ethnicity and region was observed among Indians, with Southeast Asian Indians having higher odds of AF (AOR 3.01, 95% CI 1.60–5.67) compared with South Asian Indians. AF was associated with poorer quality of life and increased risk of 1 year all‐cause mortality or HF hospitalisation (adjusted hazard ratio 1.39, 95% CI 1.18–1.63) regardless of ethnicity. CONCLUSIONS: Among patients with HF across Asia, clinical correlates and adverse outcomes associated with AF are similar across ethnicities; however, there are striking ethnic variations in the prevalence of AF that are not accounted for by known risk factors. |
format | Online Article Text |
id | pubmed-7373934 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-73739342020-07-22 Ethnic differences in atrial fibrillation among patients with heart failure in Asia Tan, Eugene S.J. Goh, Vera Santema, Bernadet T. Tay, Wan Ting Teng, Tiew‐Hwa Katherine Yap, Jonathan Tromp, Jasper Hung, Chung‐Lieh Chopra, Vijay Anand, Inder MacDonald, Michael R. Ling, Lieng Hsi Van Gelder, Isabelle C. Rienstra, Michiel Voors, Adriaan A. Richards, A. Mark Lam, Carolyn S.P. ESC Heart Fail Original Research Articles AIMS: We aimed to characterize ethnic differences in prevalence, clinical correlates, and outcomes of atrial fibrillation (AF) in heart failure (HF) with preserved and reduced ejection fraction (HFpEF and HFrEF) across Asia. METHODS AND RESULTS: Among 5504 patients with HF prospectively recruited across 11 Asian regions using identical protocols in the Asian Sudden Cardiac Death in Heart Failure study (mean age 61 ± 13 years, 27% women, 83% HFrEF), 1383 (25%) had AF defined as a history of AF and/or AF/flutter on baseline electrocardiogram. Clinical correlates of AF were similar across ethnicities and included older age, prior stroke, higher NT‐proBNP, and larger left atria. Diabetes was associated with lower odds of AF in HFrEF [adjusted odds ratio (AOR) 0.79, 95% CI 0.66–0.95] and HFpEF (AOR 0.58, 95% CI 0.39–0.84) regardless of ethnicity. Compared with Chinese ethnicity, Japanese/Koreans had higher odds of AF in HFrEF (AOR 1.76, 95% CI 1.40–2.21), while Indians had lower odds in HFrEF (AOR 0.18, 95% CI 0.13–0.24) and HFpEF (AOR 0.28, 95% CI 0.16–0.49) even after adjusting for clinical covariates. Interaction between ethnicity and region was observed among Indians, with Southeast Asian Indians having higher odds of AF (AOR 3.01, 95% CI 1.60–5.67) compared with South Asian Indians. AF was associated with poorer quality of life and increased risk of 1 year all‐cause mortality or HF hospitalisation (adjusted hazard ratio 1.39, 95% CI 1.18–1.63) regardless of ethnicity. CONCLUSIONS: Among patients with HF across Asia, clinical correlates and adverse outcomes associated with AF are similar across ethnicities; however, there are striking ethnic variations in the prevalence of AF that are not accounted for by known risk factors. John Wiley and Sons Inc. 2020-05-08 /pmc/articles/PMC7373934/ /pubmed/32383559 http://dx.doi.org/10.1002/ehf2.12696 Text en © 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Articles Tan, Eugene S.J. Goh, Vera Santema, Bernadet T. Tay, Wan Ting Teng, Tiew‐Hwa Katherine Yap, Jonathan Tromp, Jasper Hung, Chung‐Lieh Chopra, Vijay Anand, Inder MacDonald, Michael R. Ling, Lieng Hsi Van Gelder, Isabelle C. Rienstra, Michiel Voors, Adriaan A. Richards, A. Mark Lam, Carolyn S.P. Ethnic differences in atrial fibrillation among patients with heart failure in Asia |
title | Ethnic differences in atrial fibrillation among patients with heart failure in Asia |
title_full | Ethnic differences in atrial fibrillation among patients with heart failure in Asia |
title_fullStr | Ethnic differences in atrial fibrillation among patients with heart failure in Asia |
title_full_unstemmed | Ethnic differences in atrial fibrillation among patients with heart failure in Asia |
title_short | Ethnic differences in atrial fibrillation among patients with heart failure in Asia |
title_sort | ethnic differences in atrial fibrillation among patients with heart failure in asia |
topic | Original Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373934/ https://www.ncbi.nlm.nih.gov/pubmed/32383559 http://dx.doi.org/10.1002/ehf2.12696 |
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