title: Incidence of Atrial Fibrillation and Relationship With Cardiovascular Events, Heart Failure, and Mortality: A Community-Based Study From the Netherlands.
abstract: BACKGROUND
  Important improvements have been made in treatment of diseases associated with atrial fibrillation (AF), such as hypertension, myocardial infarction, and heart failure. Incidence rates and risk factors may have changed with the aging of the population and changing lifestyles. Currently, the risk for AF is only partially explained, possibly because of differences between older cohorts and contemporary populations.
  
  
  OBJECTIVE
  This study investigated the incidence of AF in a contemporary cohort in the Netherlands, together with comorbidities associated with AF and associations of AF with cardiovascular outcomes.
  
  
  METHODS
  Incident AF was ascertained for hospital and study electrocardiograms in 8,265 participants of the PREVEND (Prevention of Renal and Vascular End-Stage Disease) study in Groningen, the Netherlands.
  
  
  RESULTS
  During 9.7 ± 2.3 years of follow-up, 265 participants developed AF, with a resulting overall AF incidence of 3.3 per 1,000 person-years. Advancing age, male sex, antihypertensive drug use, higher body mass index, previous myocardial infarction, and previous stroke were associated with AF. After multivariable adjustment, AF was associated with cardiovascular events (hazard ratio [HR]: 2.24; 95% confidence interval [CI]: 1.06 to 4.75; p = 0.035), heart failure with either reduced or preserved ejection fraction (HR: 4.52; 95% CI: 2.02 to 10.09; p < 0.001), and all-cause mortality (HR: 3.02; 95% CI: 1.73 to 5.27; p < 0.001).
  
  
  CONCLUSIONS
  The incidence of AF in the present cohort was comparable to that shown in data of older studies. Obesity has become a major risk factor for incident AF. Although overall cardiovascular event rates were lower in the present study, the present study confirms the association of incident AF with such events.
authors: Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors: Rob A
authors: RA
authors: Vermond
authors: Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors: Bastiaan
authors: B
authors: Geelhoed
authors: Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors: Niek
authors: N
authors: Verweij
authors: Department of Cardiology, Martini Hospital, Groningen, the Netherlands.
authors: Robert G
authors: RG
authors: Tieleman
authors: Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors: Pim
authors: P
authors: Van der Harst
authors: Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors: Hans L
authors: HL
authors: Hillege
authors: Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors: Wiek H
authors: WH
authors: Van Gilst
authors: Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors: Isabelle C
authors: IC
authors: Van Gelder
authors: Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. Electronic address: m.rienstra@umcg.nl.
authors: Michiel
authors: M
authors: Rienstra
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology*; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology*; D009426:Netherlands / Q000453:epidemiology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis
keywords: atrial fibrillation; comorbidities; epidemiology; heart failure; mortality; outcome