Abstract P003: Trajectories of Cardiovascular Risk Factors / Outcomes and Atrial Fibrillation in a 25 Year Follow-up: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Faye L Lopez ◽  
Sunil K Agarwal ◽  
Elsayed Z Soliman ◽  
Lin Y Chen ◽  
Lindsay G Smith ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Index Date ◽  
Reference Group ◽  
Large Population ◽  
Population Based ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

Background: Little attention has been devoted to the timing of risk factor development in relation to atrial fibrillation (AF) diagnosis. We assessed the long term trajectories of risk factors and cardiovascular (CV) outcomes in the Atherosclerosis Risk in Communities (ARIC) study, a US community-based cohort. Methods: Our analysis included 2134 individuals with incident AF and 5674 controls matched with cases 1:3 on age, sex, race and center, participating in the ARIC study. Information on incident AF and risk factors / CV outcomes (obesity, hypertension, smoking, diabetes, heart failure (HF), myocardial infarction (MI), and stroke) was obtained during 5 study exams between 1987 and 2013, and surveillance of CV events through 2010. The prevalence of risk factors / CV outcomes in the period before and after the diagnosis of AF (and the corresponding index date for controls) was modeled using general estimating equations models. Adjusted odds ratios (OR) of risk factors / CV outcomes were calculated, using the index date ±2.5 years as the reference group. The interaction of time with AF was used to compare differences in trajectories. Results: During a median follow-up of 24 years, we observed diverse trajectories in the prevalence of risk factors and CV outcomes among AF patients, with steep increases in the prevalence of stroke, MI and HF during the period close to AF diagnosis, while trajectories for hypertension and diabetes showed monotonic increases, and those for smoking and obesity suggested decreases in prevalence after AF diagnosis (Figure A). The trajectories over time for hypertension, obesity, HF, stroke and MI were significantly different based on AF status, with lower increments among those without AF (Figure A and B). Conclusion: In this large population-based study, trajectories in the odds of risk factors and CV outcomes were diverse, suggesting they could have different roles in the pathogenesis of AF. The prevalence of CV outcomes increased after AF diagnosis, and trajectories differed by AF status.

Abstract 13786: Contribution of Medications and Risk Factors to QT Interval Lengthening in the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Khalid A Alburikan ◽  
Samuel T Savitz ◽  
Eric A Whitsel ◽  
James E Tisdale ◽  
Elsayed Z Soliman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Qt Interval ◽  
Ventricular Hypertrophy ◽  
Population Based ◽  
Left Ventricular ◽  
Atherosclerosis Risk In Communities ◽  
Female Sex ◽  
Atherosclerosis Risk ◽  
Aric Study

Objective: Prolongation of corrected QT interval (QTc) is associated with increased morbidity and mortality, but the association between the number of QT interval prolonging medications (QTPMs) versus selected non-pharmacologic risk factors on the magnitude of QTc lengthening is unknown. We examined these associations in a longitudinal study of a population-based cohort. Methods: We included 15,792 ARIC participants with a resting, standard 12-lead electrocardiogram and ≥ 1 measure of QTc over up to four triennial examinations between 1987 and 1998 (54,638 person-visits). Participants with QRS > 120 ms were excluded (n=2,333). To optimize clinical applicability, QTc was calculated using Bazett’s equation. At each visit, we identified participants using ≥ 1 AzCERT-classified QTPMs, age > 65 years, females, and those with left ventricular hypertrophy (LVH), or QTc > 500 ms at the prior visit. We used linear regression for 36,513 person-visit observations from visits 2-4 to examine QTc lengthening associations. Visit indicators were controlled for time, and standard errors were corrected for repeat observations per person. Results: Use of any QTPM increased from 9% to 17% between visits 1 and 4 and occurred more frequently among females and participants with LVH. Among person-visit observations from Visit 2-4, 70% (n=25,513) had at least one risk factor including age > 65 years (25%), female sex (56%), LVH (8%) and QTc>500 ms (1%). In patients receiving no QTPM, female sex was associated with the greatest QTc lengthening at 13 ms [95% CI 12-13] followed by LVH at 7 ms [6-9], QTc > 500 ms at 7 [4-10], and age > 65 at 2 ms [1-3]. Mean QTc increased with increasing number of QTPMs and risk factors (Table). The greatest QTc lengthening occurred in participants using ≥ 2 medications with ≥ 1 risk factor. Conclusions: Risk factors, particularly female sex, contribute more to QTc lengthening than QTPMs.

Abstract P108: Association of Forced Expiratory Volume (1 Second) with Incidence of Atrial Fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Jingjing Li ◽  
Sunil K Agarwal ◽  
Alvaro Alonso ◽  
Saul Blecker ◽  
Alanna M Chamberlain ◽  
...  
Keyword(s):  
Risk Factors ◽  
Black Women ◽  
Black Men ◽  
White Women ◽  
White Men ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk

Objective: To investigate the association between low forced expiratory volume in 1 second (FEV 1 ) and incident atrial fibrillation (AF) in a population-based cohort. Background: Impaired FEV 1 , a complex measure indicating genetic, developmental, obstructive and restrictive airway disease, musculoskeletal function, and motivation, has been inconsistently associated with an increased risk of cardiovascular disease mortality. Also, extant reports do not provide separate estimates for African Americans, who surprisingly have lower AF incidence than Caucasians. Methods: We examined 15,282 middle-aged African Americans (26%) and Caucasians, men (45%) and women from four U.S. communities enrolled in the Atherosclerosis Risk in Communities (ARIC) cohort study. Lung volumes by standardized spirometry and information on covariates were collected on these participants at the baseline visit (1987-1989). Prevalent AF cases were excluded by 12-lead ECG at baseline. Incident AF was defined as the first event identified from the following: ICD codes for AF from hospital discharge records or death certificates, or ECGs performed during three triennial follow-up visits. Results: Over an average follow-up of 17.5 years, a total of 1,733 (11%) participants developed new-onset AF. The rate of incident AF increased monotonically and inversely by tertiles of FEV 1 in each of the 4 gender-race strata. The unadjusted average incidence rates of AF per 100 person years of follow up by tertiles of FEV 1 (from lowest to highest tertile) were 13.6, 8.3, and 5.7 for white men; 8.7, 4.5, and 3.4 for white women; 8.2, 5.5, and 3.8 for black men; 6.9, 4.1, and 2.4 for black women. After multivariable adjustment for traditional cardiovascular disease risk factors and height, hazard ratios (95% CI) of AF comparing the lowest with the highest tertile of FEV 1 were 1.44 (1.16,1.78) among white men, 1.45 (1.12, 1.87) among white women, 1.81 (1.09, 3.02) among black men, and 1.84(1.20, 2.82) among black women. The trend estimate for per 1 Standard-Deviation lower FEV 1 for the corresponding race and gender groups were 1.21 (1.12, 1.32), 1.38 (1.25, 1.54), 1.45 (1.18, 1.76), and 1.35 (1.12, 1.63), respectively. The above associations were observed across all smoking status categories (current, former, and never). The association between low lung function and incidence of AF was similarly unchanged after exclusion of participants with heart failure (n = 689) or CHD (n = 558) at baseline. The hazard of AF was about 50% higher among those with FEV1/FVC ratio below 0.7. Conclusions: In this large population-based cohort study with a long term follow-up, reduced FEV 1 is strongly associated with a higher AF risk, independent of race, gender, smoking, and several other CVD risk factors. These findings suggest the need for research on mechanisms underlying the observed association to seek broader opportunities for prevention of AF.

Abstract P111: Serum and Dietary Magnesium and the Incidence of Atrial Fibrillation in Whites and African Americans: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Jeffrey R Misialek ◽  
Faye L Lopez ◽  
Rachel R Huxley ◽  
James M Peacock ◽  
Lin Y Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Cardiovascular Risk ◽  
African Americans ◽  
Cardiovascular Risk Factors ◽  
Serum Magnesium ◽  
The United States ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

Background: Low serum magnesium (Mg) has been associated with a higher cardiovascular risk and other cardiovascular diseases (CVD) including ventricular arrhythmias. However, the association between serum or dietary Mg and atrial fibrillation (AF) has not been investigated to date. Methods: We studied 14,290 men and women (75% white, 53% women, mean age 54) free of AF at baseline participating in the Atherosclerosis Risk in Communities (ARIC) study, a community-based cohort in the United States. Serum Mg was assessed at baseline (1987-89) and a second visit (1990-92) while dietary Mg was assessed at baseline and a third visit (1993-95). The mean value of two Mg measurements were used for individuals who attended both visits while the baseline Mg measurement was used for individuals who did not attend another visit or were censored. Incident AF cases through 2008 were ascertained from electrocardiograms, hospital discharge codes, and death certificates. Cox proportional hazards regression was used to estimate hazard ratios and 95% confidence intervals for AF associated with serum and dietary Mg quintiles. Models were initially adjusted for age, sex, race, and ARIC field center, and additional models further adjusted for other cardiovascular risk factors and prevalent CVD. Dietary Mg analyses included correlated dietary covariates in all models. Interaction by race and sex was tested for serum and dietary Mg. Results: Over a median follow-up time of 19.7 years, 1,613 incident AF cases were identified. Higher serum Mg was associated with lower AF risk even after adjustment for cardiovascular risk factors and other CVD (table), with no evidence of significant interactions between serum Mg and sex or race. No significant association was identified between dietary Mg and AF. Conclusion: High serum Mg was associated with a lower AF risk, and this association was not different between whites and African Americans. Dietary Mg was not associated with AF risk. Funding(This research has received full or partial funding support from the American Heart Association, National Center)

scholarly journals Risk factors for lacune subtypes in the Atherosclerosis Risk in Communities (ARIC) Study

Neurology ◽  
2011 ◽  
Vol 78 (2) ◽  
pp. 102-108 ◽  
Author(s):  
D. C. Bezerra ◽  
A. R. Sharrett ◽  
K. Matsushita ◽  
R. F. Gottesman ◽  
D. Shibata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

scholarly journals Vital exhaustion and sudden cardiac death in the Atherosclerosis Risk in Communities Study

Heart ◽  
2017 ◽  
Vol 104 (5) ◽  
pp. 423-429 ◽  
Author(s):  
Brittany M Bogle ◽  
Nona Sotoodehnia ◽  
Anna M Kucharska-Newton ◽  
Wayne D Rosamond
Keyword(s):  
Risk Factors ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Disease Risk ◽  
Ventricular Tachyarrhythmia ◽  
Atherosclerosis Risk In Communities ◽  
Vital Exhaustion ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Aric Study

ObjectiveVital exhaustion (VE), a construct defined as lack of energy, increased fatigue and irritability, and feelings of demoralisation, has been associated with cardiovascular events. We sought to examine the relation between VE and sudden cardiac death (SCD) in the Atherosclerosis Risk in Communities (ARIC) Study.MethodsThe ARIC Study is a predominately biracial cohort of men and women, aged 45–64 at baseline, initiated in 1987 through random sampling in four US communities. VE was measured using the Maastricht questionnaire between 1990 and 1992 among 13 923 individuals. Cox proportional hazards models were used to examine the hazard of out-of-hospital SCD across tertiles of VE scores.ResultsThrough 2012, 457 SCD cases, defined as a sudden pulseless condition presumed due to a ventricular tachyarrhythmia in a previously stable individual, were identified in ARIC by physician record review. Adjusting for age, sex and race/centre, participants in the highest VE tertile had an increased risk of SCD (HR 1.48, 95% CI 1.17 to 1.87), but these findings did not remain significant after adjustment for established cardiovascular disease risk factors (HR 0.94, 95% CI 0.73 to 1.20).ConclusionsAmong participants of the ARIC study, VE was not associated with an increased risk for SCD after adjustment for cardiovascular risk factors.

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