title: Outcomes Associated With Familial Versus Nonfamilial Atrial Fibrillation: A Matched Nationwide Cohort Study.
abstract: We examined all-cause mortality and long-term thromboembolic risk (ischemic stroke, transient ischemic attack, systemic thromboembolism) in patients with and without familial atrial fibrillation (AF).
  
  
  
  Using Danish nationwide registry data, we identified all patients diagnosed with AF (1995-2012) and divided them into those with familial AF (having a first-degree family member with a prior AF admission) and those with nonfamilial AF. We paired those with and without familial AF according to age, year of AF diagnosis, and sex in a 1:1 match. Using cumulative incidence and multivariable Cox models, we examined the risk of long-term outcomes. We identified 8658 AF patients (4329 matched pairs) with and without familial AF. The median age was 50 years (interquartile range 43-54 years), and 21.4% were women. Compared with nonfamilial AF patients, those with familial AF had slightly less comorbid illness but similar overall CHA2DS2-VASc score (P=0.155). Median follow-up was 3.4 years (interquartile range 1.5-6.5 years). Patients with familial AF had risk of death and thromboembolism similar to those with nonfamilial AF (adjusted hazard ratio 0.91 [95% CI 0.79-1.04] for death and 0.90 [95% CI 0.71-1.14] for thromboembolism).
  
  
  
  Although family history of AF is associated with increased likelihood for development of AF, once AF developed, long-term risks of death and thromboembolic complications were similar in familial and nonfamilial AF patients.
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark annagundlund@gmail.com.
authors.forename: Anna
authors.initials: A
authors.lastname: Gundlund
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark.
authors.forename: Jonas Bjerring
authors.initials: JB
authors.lastname: Olesen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark.
authors.forename: Laila
authors.initials: L
authors.lastname: Staerk
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark.
authors.forename: Christina
authors.initials: C
authors.lastname: Lee
authors.affiliation: Duke Clinical Research Institute, Durham, NC.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Piccini
authors.affiliation: Duke Clinical Research Institute, Durham, NC.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
authors.affiliation: Department of Cardiology, University Hospital of Copenhagen, Rigshospitalet, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.affiliation: Department of Epidemiology, University of Aalborg, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark.|The Danish Heart Foundation, Copenhagen, Denmark.|The National Institute of Public Health, University of Southern Denmark, Odense, Denmark.
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Gislason
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark.|Department of Cardiology, University Hospital of Copenhagen, Rigshospitalet, Denmark.|The Danish Heart Foundation, Copenhagen, Denmark.
authors.forename: Emil Loldrup
authors.initials: EL
authors.lastname: Fosbøl
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000150:complications / Q000235:genetics*; D016022:Case-Control Studies; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012042:Registries; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D013923:Thromboembolism / Q000453:epidemiology* / Q000209:etiology
keywords: atrial flutter; complication; family history; genetics