Cited by 4,575Atrial Fibrillation Management and OutcomesCardiac Health and Mental HealthCardiac electrophysiology and arrhythmias

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Impact of Atrial Fibrillation on the Risk of Death: The Framingham Heart Study

Benjamin, Emelia J., Wolf, Philip A., D’Agostino, Ralph B., Silbershatz, Halit, Kannel, William B., Levy, Daniel·1998·Circulation

DOI 10.1161/01.cir.98.10.946

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Abstract

Background —Atrial fibrillation (AF) causes substantial morbidity. It is uncertain whether AF is associated with excess mortality independent of associated cardiac conditions and risk factors. Methods and Results —We examined the mortality of subjects 55 to 94 years of age who developed AF during 40 years of follow-up of the original Framingham Heart Study cohort. Of the original 5209 subjects, 296 men and 325 women (mean ages, 74 and 76 years, respectively) developed AF and met eligibility criteria. By pooled logistic regression, after adjustment for age, hypertension, smoking, diabetes, left ventricular hypertrophy, myocardial infarction, congestive heart failure, valvular heart disease, and stroke or transient ischemic attack, AF was associated with an OR for death of 1.5 (95% CI, 1.2 to 1.8) in men and 1.9 (95% CI, 1.5 to 2.2) in women. The risk of mortality conferred by AF did not significantly vary by age. However, there was a significant AF-sex interaction: AF diminished the female advantage in survival. In secondary multivariate analyses, in subjects free of valvular heart disease and preexisting cardiovascular disease, AF remained significantly associated with excess mortality, with about a doubling of mortality in both sexes. Conclusions —In subjects from the original cohort of the Framingham Heart Study, AF was associated with a 1.5- to 1.9-fold mortality risk after adjustment for the preexisting cardiovascular conditions with which AF was related. The decreased survival seen with AF was present in men and women and across a wide range of ages.

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Authors: Benjamin, E. J., Wolf, P. A., D’Agostino, R. B., Silbershatz, H., Kannel, W. B., & Levy, D.
Affiliations: Boston University (US)
ORCID: Benjamin, Emelia J.
Wolf, Philip A.
D’Agostino, Ralph B.
Levy, Daniel
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1998-09-08
Volume: 98
Issue: 10
Pages: 946-952
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.98.10.946
OpenAlex: W2151074096
Cited by: 4,575
References: 37
Citations by year: 2026: 76 · 2025: 123 · 2024: 146 · 2023: 149 · 2022: 189 · 2021: 242 · 2020: 225 · 2019: 206 · 2018: 215 · 2017: 237 · 2016: 238 · 2015: 232 · 2014: 230 · 2013: 279 · 2012: 237
FWCI: 35.84
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (n01hc038038-022, 2r01ns017590-07a1)
National Heart, Lung, and Blood Institute (N01-HC-38038)
National Institute of Neurological Disorders and Stroke (5-R01-NS-17590-16)
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 › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords: atrial fibrillation, mortality risk, sex differences in survival, Framingham Heart Study, older adults, cardiovascular disease, valvular heart disease, congestive heart failure, left ventricular hypertrophy
MeSH terms: Adult, Age Factors, Aged, Aged, 80 and over, Atrial Fibrillation, Blood Pressure, Ischemic Attack, Transient, Cerebrovascular Disorders, Diabetes Mellitus, Female, Follow-Up Studies, Heart Failure, Heart Valve Diseases, Humans, Hypertension, Male, Massachusetts, Middle Aged, Myocardial Infarction, Regression Analysis, Risk Factors, Sex Factors, Smoking, Time Factors, Cohort Studies

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Impact of Atrial Fibrillation on the Risk of Death: The Framingham Heart Study

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