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A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew/Paisley study
Abstract
Purpose To describe the effect of atrial fibrillation on long-term morbidity and mortality.Subjects and methods The Renfrew/Paisley Study surveyed 7052 men and 8354 women aged 45-64 years between 1972 and 1976. All hospitalizations and deaths occurring during the subsequent 20 years were analyzed by the presence or absence of atrial fibrillation at baseline. Lone atrial fibrillation was defined in the absence of other cardiovascular signs or symptoms. Cox proportional hazards models were used to adjust for age and cardiovascular conditions.Results After 20 years, 42 (89%) of the 47 women with atrial fibrillation had a cardiovascular event (death or hospitalization), compared with 2276 (27%) of the 8307 women without this arrhythmia. Among men, 35 (66%) of 53 with atrial fibrillation had an event, compared with 3151 (45%) of 6999 without atrial fibrillation. In women, atrial fibrillation was an independent predictor of cardiovascular events (rate ratio [RR] = 3.0; 95% confidence interval [CI]: 2.1-4.2), fatal or nonfatal strokes (RR = 3.2; 95% CI: 1.0-5.0), and heart failure (RR = 3.4; 95% CI: 1.9-6.2). The rate ratios among men were 1.8 (95% CI: 1.3-2.5) for cardiovascular events, 2.5 (95% CI: 1.3-4.8) for strokes, and 3.4 (95% CI: 1.7-6.8) for heart failure. Atrial fibrillation was an independent predictor of all-cause mortality in women (RR = 2.2; 95% CI: 1.5-3.2) and men (RR = 1.5; 95% CI: 1.2-2.2). However, lone atrial fibrillation (which occurred in 15 subjects) was not associated with a statistically significant increase in either cardiovascular events (RR = 1.5; 95% CI: 0.6-3.6) or mortality (RR = 1.8; 95% CI: 0.9-3.8).Conclusions Atrial fibrillation is associated with an increased long-term risk of stroke, heart failure, and all-cause mortality, especially in women.
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“In a rabbit model, left atrial and pulmonary vein tissue from females displayed longer action potential duration, and female pulmonary vein tissue had a more negative resting membrane potential compared with males.147”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [147]
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Metadata
- Authors
- Stewart, S., Hart, C. L., Hole, D. J., & McMurray, J. J. V.
- Affiliations
- University of South Australia (AU)
- University of Glasgow (GB)
- Corresponding author
- McMurray, John J.V
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 2002-10
- Volume
- 113
- Issue
- 5
- Pages
- 359-364
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W1971505725
- Cited by
- 1,562
- References
- 33
- Citations by year
- 2026: 26 · 2025: 34 · 2024: 67 · 2023: 45 · 2022: 64 · 2021: 94 · 2020: 129 · 2019: 88 · 2018: 92 · 2017: 81 · 2016: 100 · 2015: 107 · 2014: 97 · 2013: 85 · 2012: 83
- FWCI
- 7.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
- Keywords
- atrial fibrillation, long-term morbidity, cardiovascular mortality, stroke, heart failure, sex differences, lone atrial fibrillation, middle-aged adults, cardiovascular hospitalization, all-cause mortality, cardiovascular risk factors, atrial fibrillation risk factors, atrial fibrillation treatment, atrial fibrillation prevention, atrial fibrillation screening
- MeSH terms
- Atrial Fibrillation, Cardiovascular Diseases, Female, Follow-Up Studies, Humans, Male, Middle Aged, Risk Factors, Scotland, Time Factors, Cohort Studies, Survival Rate, Proportional Hazards Models, Outcome Assessment, Health Care
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