Early-life antecedents of atrial fibrillation: place of birth and atrial fibrillation-related mortality.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Patton, KK; Benjamin, EJ; Kosheleva, A; Curtis, LH; Glymour, MM

Published Date

  • October 2011

Published In

Volume / Issue

  • 21 / 10

Start / End Page

  • 732 - 738

PubMed ID

  • 21798760

Pubmed Central ID

  • PMC3166377

Electronic International Standard Serial Number (EISSN)

  • 1873-2585

Digital Object Identifier (DOI)

  • 10.1016/j.annepidem.2011.06.003


  • eng

Conference Location

  • United States