Open AccessOutcomes Associated With Familial Versus Nonfamilial Atrial Fibrillation: A Matched Nationwide Cohort Study
Author(s) -
Gundlund Anna,
Olesen Jonas Bjerring,
Staerk Laila,
Lee Christina,
Piccini Jonathan P.,
Peterson Eric D.,
Køber Lars,
TorpPedersen Christian,
Gislason Gunnar H.,
Fosbøl Emil Loldrup
Publication year - 2016
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.116.003836
Subject(s) - medicine , interquartile range , atrial fibrillation , hazard ratio , cohort , proportional hazards model , stroke (engine) , cumulative incidence , family history , cardiology , incidence (geometry) , cohort study , confidence interval , pediatrics , mechanical engineering , physics , optics , engineering
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 CHA 2 DS 2 ‐ VAS c 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.