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Am J Cardiol. 2014 Nov 1;114(9):1368-72. doi: 10.1016/j.amjcard.2014.07.073. Epub 2014 Aug 18.

Risk factors for atrial fibrillation in patients with normal versus dilated left atrium (from the Atherosclerosis Risk in Communities Study).

Author information

1
Section of Cardiology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Electronic address: WQureshi@Wakehealth.edu.
2
Section of Cardiology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina; Epidemiological Cardiology Research Center, Wake Forest School of Medicine, Winston-Salem, North Carolina; Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina.
3
Department of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
4
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
5
McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
6
Division of Cardiology, Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
7
Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
8
Section of Cardiology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.

Abstract

Epidemiological data are limited regarding risk factors of atrial fibrillation (AF) in patients with normal-sized left atria (LA). We evaluated whether traditional risk factors of AF differ between patients with normal-sized and dilated LA. This is a cross sectional study of community-dwelling participants of the Atherosclerosis Risk in Communities study. LA volume index was measured by 2-dimensional echocardiography. LA volume index ≥29 mm(3)/m(2) defined dilated LA. Prevalent AF was defined by electrocardiogram and hospital discharge International Classification of Diseases-9 codes. Multivariate adjusted logistic regression analysis was used to examine whether magnitude of association of risk factors with AF differ by LA cavity size. Interaction of risk factors by LA cavity size was evaluated to determine significance of these differential associations. Of 5,496 participants (mean age 75 ± 5 years, women 58%), 1,230 participants (22%) had dilated LA. The prevalence of AF was 11% in patients with normal-sized LA and 15% in patients with dilated LA. Age >75 years (odds ratio [OR] 1.87, 95% confidence interval [CI] 1.49 to 2.35, interaction p = 0.12) and heart failure (OR 5.43, 95% CI 3.77 to 7.87, interaction p = 0.10) were stronger risk factors for AF in normal-sized LA than dilated LA. Female gender (OR 1.67, 95% CI 1.01 to 2.77, interaction p = 0.09), weight (OR 1.32, 95% CI 1.02 to 1.71, interaction p = 0.19), and alcohol use (OR 1.61, 95% CI 1.08 to 2.41, interaction p = 0.004) were stronger risk factors for AF in patients with dilated LA than normal-sized LA. In conclusion, risk factors of AF may differ by left ventricular cavity size.

PMID:
25245413
PMCID:
PMC4195803
DOI:
10.1016/j.amjcard.2014.07.073
[Indexed for MEDLINE]
Free PMC Article

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