Abstract
Background-We examined all-cause mortality and long-term thromboembolic risk (ischemic stroke, transient ischemic attack, systemic thromboembolism) in patients with and without familial atrial fibrillation (AF). Methods and Results-Using Danish nationwide registry data, we identified all patients diagnosed with AF (1995-2012) and divided them into those with familial AF (having a first-degree family member with a prior AF admission) and those with nonfamilial AF. We paired those with and without familial AF according to age, year of AF diagnosis, and sex in a 1:1 match. Using cumulative incidence and multivariable Cox models, we examined the risk of long-term outcomes. We identified 8658 AF patients (4329 matched pairs) with and without familial AF. The median age was 50 years (interquartile range 43-54 years), and 21.4% were women. Compared with nonfamilial AF patients, those with familial AF had slightly less comorbid illness but similar overall CHA2DS2-VASc score (P = 0.155). Median follow-up was 3.4 years (interquartile range 1.5-6.5 years). Patients with familial AF had risk of death and thromboembolism similar to those with nonfamilial AF (adjusted hazard ratio 0.91 [95% CI 0.79-1.04] for death and 0.90 [95% CI 0.71-1.14] for thromboembolism). Conclusions-Although family history of AF is associated with increased likelihood for development of AF, once AF developed, long-term risks of death and thromboembolic complications were similar in familial and nonfamilial AF patients.
| Original language | English |
|---|---|
| Article number | e003836 |
| Journal | Journal of the American Heart Association |
| Volume | 5 |
| Issue number | 11 |
| Number of pages | 14 |
| ISSN | 2047-9980 |
| DOIs | |
| Publication status | Published - 2016 |
Bibliographical note
ISI Document Delivery No.: EG1IU Times Cited: 1 Cited Reference Count: 26 Gundlund, Anna Olesen, Jonas Bjerring Staerk, Laila Lee, Christina Piccini, Jonathan P. Peterson, Eric D. Kober, Lars Torp-Pedersen, Christian Gislason, Gunnar H. Fosbol, Emil Loldrup Bristol-Myers Squibb; Boehringer Ingelheim; Capital Region of Denmark; Foundation for Health Research Ms Gundlund reports grants from Bristol-Myers Squibb outside the submitted work. Dr Olesen received speaker fees from Bristol-Myers Squibb and Boehringer Ingelheim, and funding for research from Bristol-Myers Squibb and The Capital Region of Denmark, Foundation for Health Research. Dr Staerk reports grants from Boehringer Ingelheim outside the submitted work. Dr Piccini reports grants from ARCA biopharma, grants from Boston Scientific, grants from Gilead, grants from Johnson & Johnson, grants from ResMed, grants from St Jude Medical, personal fees from Laguna Pharmaceuticals, personal fees from Medtronic, personal fees from Pfizer/BMS, personal fees from Spectranetics, outside the submitted work. Dr Peterson reports grants and personal fees from Janssen, personal fees from Boehringer Ingelheim, personal fees from Bayer, personal fees from Sanofi, personal fees from Astra Zeneca, personal fees from Merck, outside the submitted work. Dr Kober reports personal fees from Honorarium as speaker for Servier and Novartis, outside the submitted work. Dr Torp-Pedersen reports grants and personal fees from Bayer, grants, and personal fees from Bristol Mayer, outside the submitted work. Dr Gislason reports grants from AstraZeneca, grants from Bristol-Myers Squibb, grants from Bayer, grants from Boehringer Ingelheim, outside the submitted work. The remaining authors have no disclosures to report. 1 Wiley-blackwell HobokenKeywords
- atrial flutter complication family history genetics danish twins risk aggregation registry variants stroke onset locus zfhx3 Cardiovascular System & Cardiology