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Early-life antecedents of atrial fibrillation: place of birth and atrial fibrillation-related mortality.

Authors
Patton-KK; Benjamin-EJ; Kosheleva-A; Curtis-LH; Glymour-MM
Source
Ann Epidemiol 2011 Oct; 21(10):732-738
NIOSHTIC No.
20040144
Abstract
PURPOSE: Recent evidence suggests early-life factors correlate with atrial fibrillation (AF). We hypothesized that AF-related mortality, similar to stroke mortality, is elevated for individuals born in the southeastern United States. METHODS: We estimated 3-year (1999-2001) average AF-related mortality rates by using U.S. vital statistics for 55- to 89-year-old white (136,573 AF-related deaths) and black subjects (8,288 AF-related deaths). We estimated age- and sex-adjusted odds of AF-related (contributing cause) mortality associated with birth state, and birth within the U.S. stroke belt (SB), stratified by race. SB results were replicated with the use of 1989-1991 data. RESULTS: Among black subjects, four contiguous birth states were associated with statistically significant odds ratios = 1.25 compared with the national average AF-related mortality. The four highest-risk birth states for blacks also predicted elevated AF-related mortality among white subjects, but patterns were attenuated. The odds ratio for AF-related mortality associated with SB birth was 1.19 (confidence interval 1.13-1.25) for black and 1.09 (CI 1.07-1.12) for white subjects when we adjusted for SB adult residence. CONCLUSIONS: Place of birth predicted AF-related mortality, after we adjusted for place of adult residence. The association of AF-related mortality and SB birth parallels that of other cardiovascular diseases and may likewise indicate an importance of early life factors in the development of AF.
Keywords
Heart; Cardiac-function; Vital-capacity; Statistical-analysis; Mortality-data; Mortality-rates; Racial-factors; Age-groups; Sex-factors; Cardiovascular-system; Cardiovascular-system-disorders; Environmental-factors; Lifespan; Risk-analysis; Risk-factors; Humans; Men; Women; Region-4; Author Keywords: Atrial Fibrillation; Geographic; Lifecourse Mortality; Residence
Contact
Kristen K. Patton, MD, University of Washington Medical Center, 1959 NE Pacific Street, Box 356422, Seattle, WA 98195
CODEN
ANNPE3
Publication Date
20111001
Document Type
Journal Article
Email Address
krpatton@u.washington.edu
Funding Type
Grant
Fiscal Year
2012
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R03-OH-009338; B01182012
Issue of Publication
10
ISSN
1047-2797
Source Name
Annals of Epidemiology
State
WA; MA; NC
Performing Organization
Harvard University School of Public Health
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