Early-life antecedents of atrial fibrillation: place of birth and atrial fibrillation-related mortality.
Patton-KK; Benjamin-EJ; Kosheleva-A; Curtis-LH; Glymour-MM
Ann Epidemiol 2011 Oct; 21(10):732-738
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.
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
Kristen K. Patton, MD, University of Washington Medical Center, 1959 NE Pacific Street, Box 356422, Seattle, WA 98195
Annals of Epidemiology
Harvard University School of Public Health