title: Atrial Fibrillation and Cardiovascular Outcomes in the Elderly.
abstract: BACKGROUND
  Prior studies have not examined which cardiovascular outcomes most frequently develop in participants with atrial fibrillation (AF) from population-based cohorts of the elderly.
  
  
  METHODS
  This analysis included 4,304 (85% white; 61% women) participants from the Cardiovascular Health Study who were free of baseline cardiovascular disease. AF cases were identified at baseline and as time-updated events during follow-up. Kaplan-Meier estimates were used to compute the 1-, 5-, 10-, and 15-year cumulative incidence rates of the following outcomes: coronary heart disease (CHD), myocardial infarction (MI), heart failure, and ischemic stroke. Cox regression was used to compute hazard ratios (HR) and 95% confidence intervals (CI) for the association between AF and each outcome.
  
  
  RESULTS
  For all time periods, the cumulative incidence estimates of CHD, MI, heart failure, and ischemic stroke were higher for those with AF compared with those without AF. Heart failure was the most frequent outcome in those with AF, while CHD events were the most frequently detected outcome in participants without AF. Compared with persons who did not have AF, the risk of heart failure was higher in those with AF (HR = 3.18, 95% CI = 2.78-3.64), and the magnitude of this association was greater than the other outcomes of interest (CHD: HR = 1.76, 95% CI = 1.54-2.03; MI: 1.40, 95% CI = 1.14-1.71; ischemic stroke: HR = 1.98, 95% CI = 1.63-2.39).
  
  
  CONCLUSIONS
  AF is associated with several adverse cardiovascular outcomes and heart failure is the most frequently detected event. Potentially, risk factor modification strategies for the primary prevention of heart failure will reduce the morbidity and mortality associated with AF.
authors.affiliation: Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia. wesley.oneal@emory.edu.
authors.forename: Wesley T
authors.initials: WT
authors.lastname: O'Neal
authors.affiliation: Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Taufiq
authors.initials: T
authors.lastname: Salahuddin
authors.affiliation: Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Broughton
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.|Department of Epidemiology and Prevention, Epidemiological Cardiology Research Center, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Elsayed Z
authors.initials: EZ
authors.lastname: Soliman
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000401:mortality*; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000401:mortality*; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006333:Heart Failure / Q000401:mortality*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality*; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D020521:Stroke / Q000401:mortality*; D015996:Survival Rate; D014481:United States / Q000453:epidemiology
keywords: atrial fibrillation; epidemiology; outcomes