Racial Differences in Atrial Fibrillation Prevalence and Left Atrial Size

Overview

Journal Am J Med

Specialty General Medicine

Date 2010 Mar 16

PMID 20227049

Citations 44

Authors

Gregory M Marcus

Jeffrey E Olgin

Mary Whooley

Eric Vittinghoff

Katie L Stone

Reena Mehra

Stephen B Hulley

Nelson B Schiller

Affiliations

Soon will be listed here.

Abstract

Background: Previous studies relying on clinical care data have suggested that atrial fibrillation is less common in African Americans than Caucasians, but the mechanism remains unknown. Clinical care may itself vary by race, potentially affecting the accuracy of atrial fibrillation ascertainment in studies relying on clinical data. We sought to examine racial differences in atrial fibrillation prevalence determined by protocol-driven electrocardiograms (ECGs) obtained in prospective cohort studies and to study racial differences in echocardiographic characteristics.

Methods: We pooled primary data from 3 cohort studies with atrial fibrillation adjudicated from study protocol ECGs and documentation of potentially important confounders: the Heart and Soul Study (n=1014), the Heart and Estrogen-Progestin Replacement Study (n=2673), and The Osteoporotic Fractures in Men Sleep Study (n=2911). Left atrial anatomic dimensions were compared among races from sinus rhythm echocardiograms in the Heart and Soul Study.

Results: Of the 6611 participants, 268 (4%) had atrial fibrillation: Caucasians had the highest prevalence (5%), and African Americans had the lowest (1%; P<.001 for each compared with all other races). After adjustment for potential confounders, Caucasians had a 3.8-fold greater odds of having atrial fibrillation than African Americans (95% confidence interval, 1.6-8.8, P=.002). Although ventricular and atrial volumes and function were similar in Caucasians and African Americans, Caucasians had a 2 mm larger anterior-posterior left atrial diameter after adjusting for potential confounders (95% confidence interval, 1-3 mm, P<.001).

Conclusion: ECG confirmed atrial fibrillation is more common in Caucasians than in African Americans, which might be related to the larger left atrial diameter observed in Caucasians.

Citing Articles

Ethnic Differences in Atrial Fibrillation in the United Kingdom.

Frimodt-Moller E, Tang J, Biering-Sorensen T, Delling F, Jackson 2nd L, Marcus G JACC Adv. 2025; 3(12):101043.

PMID: 39817084 PMC: 11734043. DOI: 10.1016/j.jacadv.2024.101043.

Atrial fibrillation in Black American patients: A review of genetics, risk factors, and outcomes.

Houmsse A, Malhotra N, Smith S, El Refaey M Heart Rhythm. 2024; 22(3):617-626.

PMID: 39515500 PMC: 11875954. DOI: 10.1016/j.hrthm.2024.10.074.

Construction and validation of a risk prediction model for 3- and 5-year new-onset atrial fibrillation in HFpEF patients.

Wang S, Xie Z, Wang F, Zhang W Front Cardiovasc Med. 2024; 11:1429431.

PMID: 39221425 PMC: 11362097. DOI: 10.3389/fcvm.2024.1429431.

Assessing ascertainment bias in atrial fibrillation across US minority groups.

Hulstaert L, Boehme A, Hood K, Hayden J, Jackson C, Toyip A PLoS One. 2024; 19(4):e0301991.

PMID: 38626094 PMC: 11020362. DOI: 10.1371/journal.pone.0301991.

Establishment and evaluation of a nomogram for in-hospital new-onset atrial fibrillation after percutaneous coronary intervention for acute myocardial infarction.

Tu J, Ye Z, Cao Y, Xu M, Wang S Front Cardiovasc Med. 2024; 11:1370290.

PMID: 38562185 PMC: 10982328. DOI: 10.3389/fcvm.2024.1370290.

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