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Racial variation in the prevalence of atrial fibrillation among patients with heart failure: the Epidemiology, Practice, Outcomes, and Costs of Heart Failure (EPOCH) study.
J Am Coll Cardiol. 2004 Feb 04; 43(3):429-35.JACC

Abstract

OBJECTIVES

This study was designed to determine the association between race and atrial fibrillation (AF) among patients with heart failure (HF).

BACKGROUND

Atrial fibrillation is known to complicate HF, but whether its prevalence varies by race, and the reasons why, are not well understood.

METHODS

We identified adults hospitalized with confirmed HF within a large integrated healthcare delivery system. We obtained information on demographics, comorbidity, vital signs, medications, and left ventricular systolic function status. "Atrial fibrillation" was defined as AF or atrial flutter documented by electrocardiogram or prior physician-assigned diagnoses. We evaluated the independent relationship between race and AF using multivariable logistic regression.

RESULTS

Among 1,373 HF patients (223 African Americans, 1,150 Caucasians), the prevalence of AF was 36.9% (95% confidence interval [CI] 34.3% to 39.5%). Compared with Caucasians, African Americans were younger (mean age 67 vs. 74 years, p < 0.001) and more likely to have hypertension (86.6% vs. 77.7%, p < 0.01) and prior diagnosed HF (79.4% vs. 70.7%, p < 0.01). African Americans had less prior diagnosed coronary disease, revascularization, hypothyroidism, or valve replacement. Atrial fibrillation was much less prevalent in African Americans (19.7%) than Caucasians (38.3%, p < 0.001). After adjustment for risk factors for AF and other potential confounders, African Americans had 49% lower odds of AF (adjusted odds ratio 0.51, 95% CI 0.35 to 0.76).

CONCLUSIONS

In a contemporary HF cohort, AF was significantly less common among African Americans than among Caucasians. This variation was not explained by differences in traditional risk factors for AF, HF etiology and severity, and treatment.

Authors+Show Affiliations

General Internal Medicine Section, San Francisco Veterans Administration Medical Center, San Francisco, California, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15013126

Citation

Ruo, Bernice, et al. "Racial Variation in the Prevalence of Atrial Fibrillation Among Patients With Heart Failure: the Epidemiology, Practice, Outcomes, and Costs of Heart Failure (EPOCH) Study." Journal of the American College of Cardiology, vol. 43, no. 3, 2004, pp. 429-35.
Ruo B, Capra AM, Jensvold NG, et al. Racial variation in the prevalence of atrial fibrillation among patients with heart failure: the Epidemiology, Practice, Outcomes, and Costs of Heart Failure (EPOCH) study. J Am Coll Cardiol. 2004;43(3):429-35.
Ruo, B., Capra, A. M., Jensvold, N. G., & Go, A. S. (2004). Racial variation in the prevalence of atrial fibrillation among patients with heart failure: the Epidemiology, Practice, Outcomes, and Costs of Heart Failure (EPOCH) study. Journal of the American College of Cardiology, 43(3), 429-35.
Ruo B, et al. Racial Variation in the Prevalence of Atrial Fibrillation Among Patients With Heart Failure: the Epidemiology, Practice, Outcomes, and Costs of Heart Failure (EPOCH) Study. J Am Coll Cardiol. 2004 Feb 4;43(3):429-35. PubMed PMID: 15013126.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial variation in the prevalence of atrial fibrillation among patients with heart failure: the Epidemiology, Practice, Outcomes, and Costs of Heart Failure (EPOCH) study. AU - Ruo,Bernice, AU - Capra,Angela M, AU - Jensvold,Nancy G, AU - Go,Alan S, PY - 2003/02/03/received PY - 2003/08/05/revised PY - 2003/09/17/accepted PY - 2004/3/12/pubmed PY - 2004/4/16/medline PY - 2004/3/12/entrez SP - 429 EP - 35 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 43 IS - 3 N2 - OBJECTIVES: This study was designed to determine the association between race and atrial fibrillation (AF) among patients with heart failure (HF). BACKGROUND: Atrial fibrillation is known to complicate HF, but whether its prevalence varies by race, and the reasons why, are not well understood. METHODS: We identified adults hospitalized with confirmed HF within a large integrated healthcare delivery system. We obtained information on demographics, comorbidity, vital signs, medications, and left ventricular systolic function status. "Atrial fibrillation" was defined as AF or atrial flutter documented by electrocardiogram or prior physician-assigned diagnoses. We evaluated the independent relationship between race and AF using multivariable logistic regression. RESULTS: Among 1,373 HF patients (223 African Americans, 1,150 Caucasians), the prevalence of AF was 36.9% (95% confidence interval [CI] 34.3% to 39.5%). Compared with Caucasians, African Americans were younger (mean age 67 vs. 74 years, p < 0.001) and more likely to have hypertension (86.6% vs. 77.7%, p < 0.01) and prior diagnosed HF (79.4% vs. 70.7%, p < 0.01). African Americans had less prior diagnosed coronary disease, revascularization, hypothyroidism, or valve replacement. Atrial fibrillation was much less prevalent in African Americans (19.7%) than Caucasians (38.3%, p < 0.001). After adjustment for risk factors for AF and other potential confounders, African Americans had 49% lower odds of AF (adjusted odds ratio 0.51, 95% CI 0.35 to 0.76). CONCLUSIONS: In a contemporary HF cohort, AF was significantly less common among African Americans than among Caucasians. This variation was not explained by differences in traditional risk factors for AF, HF etiology and severity, and treatment. SN - 0735-1097 UR - https://www.unboundmedicine.com/medline/citation/15013126/Racial_variation_in_the_prevalence_of_atrial_fibrillation_among_patients_with_heart_failure:_the_Epidemiology_Practice_Outcomes_and_Costs_of_Heart_Failure__EPOCH__study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735109703014840 DB - PRIME DP - Unbound Medicine ER -