Introduction:
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the United States; however a paucity of population-based data about nonwhite individuals exist. The objectives of this study were to compare hospitalizations among Whites and African Americans (AA) and to determine whether race is an independent predictor of hospitalization for AF in the United States.
Methods:
Data was obtained from the National Hospital Discharge Survey (years 1996 –2005) and included hospitalizations with a principal diagnosis of AF for patients aged ≥18 yrs and race designated as either White or AA. Codes from the
International Classification of Diseases
-9th revision were used to define AF (427.31), hypertension (401– 405), ischemic heart disease (410 – 414), diabetes mellitus (250), heart failure (425,428) and valvular heart disease (424). Multivariable analysis with logistic regression was used to identify factors that were independently associated with AF hospitalizations
Results:
Among 297,962,043 hospitalizations between 1996 –2005, 3,676,787 (1.2%) had a principal diagnosis of AF. Among the hospitalizations for AF, white race was more common than AA race (2,393,659/186,904,962 of whites (1.3% of white’s hospitalized) and 209,788/33,972,665 of African Americans (0.6% of AA’s hospitalized), p<0.0001). After adjusting for the most common risk factors for AF (age, sex, hypertension, ischemic heart disease, diabetes mellitus, heart failure and valvular heart disease) AA race was independently associated with a decreased odds of hospitalizations for AF (Table 1
: adjusted OR=0.49, 95%CI 0.46 – 0.51).
Conclusions:
After adjusting for the most common risk factors for AF, the odds of hospitalization for AF in AA’s remained half that of whites. Race may be a novel and unaccounted risk factor for atrial fibrillation.
Rural-Urban Differences in Mortality From Ischemic Heart Disease, Heart Failure, and Stroke in the United States
