Early Life Antecedents of Atrial Fibrillation: Place of Birth and Atrial Fibrillation Related Mortality
Published Date:Jul 27 2011
Source:Ann Epidemiol. 2011; 21(10):732-738.
Pubmed Central ID:PMC3166377
Funding:1 R91 AG927321/AG/NIA NIH HHS/United States
1R01AG027122-01A2/AG/NIA NIH HHS/United States
1R01HL092577/HL/NHLBI NIH HHS/United States
1R01HL102214/HL/NHLBI NIH HHS/United States
1R03CA137666-01A1/CA/NCI NIH HHS/United States
1R03OH009338-01/OH/NIOSH CDC HHS/United States
1RC1 HL101056/HL/NHLBI NIH HHS/United States
N01-HC-25195/HC/NHLBI NIH HHS/United States
R01 AG028321/AG/NIA NIH HHS/United States
R01 AG028321-01/AG/NIA NIH HHS/United States
R01 HL092577/HL/NHLBI NIH HHS/United States
R01 HL092577-03/HL/NHLBI NIH HHS/United States
R21AG03438501/AG/NIA NIH HHS/United States
RC1 HL101056/HL/NHLBI NIH HHS/United States
RC1 HL101056-01/HL/NHLBI NIH HHS/United States
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 US.
We estimated 3-year (1999-2001) average AF-related mortality rates, using US vital statistics for 55-89 year old whites (136,573 AF-related deaths) and blacks (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 US stroke belt (SB), stratified by race. SB results were replicated using 1989-1991 data.
Among blacks, four contiguous birth states were associated with statistically significant ORs>=1.25 compared to the national average AF-related mortality. The four highest-risk birth states for blacks also predicted elevated AF-related mortality among whites, but patterns were attenuated. The odds ratio for AF-related mortality associated with SB birth was 1.19 (CI 1.13, 1.25) for blacks and 1.09 (CI 1.07, 1.12) for whites, adjusting for SB adult residence.
Place of birth predicted AF-related mortality, after adjusting 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.
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