title: Early-life antecedents of atrial fibrillation: place of birth and atrial fibrillation-related mortality.
abstract: OBJECTIVE
  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.
authors.affiliation: Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA 98195, USA. krpatton@u.washington.edu
authors.forename: Kristen K
authors.initials: KK
authors.lastname: Patton
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.forename: Anna
authors.initials: A
authors.lastname: Kosheleva
authors.forename: Lesley H
authors.initials: LH
authors.lastname: Curtis
authors.forename: M Maria
authors.initials: MM
authors.lastname: Glymour
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000208:ethnology* / Q000401:mortality*; D005260:Female; D005843:Geography / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D015144:Southeastern United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*