Racial Differences in Device-Detected Incident Atrial Fibrillation

IF 8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Clinical electrophysiology Pub Date : 2025-02-01 DOI:10.1016/j.jacep.2024.10.006

Jack A. Goergen MD , Graham Peigh MD, MSc , Nathan Varberg BS , Paul D. Ziegler MS , Anthony I. Roberts MSc , Evan Stanelle MS , Dana Soderlund MPH , Sadiya S. Khan MD, MS , Rod S. Passman MD, MSCE

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引用次数: 0

Abstract

Background

Prior research suggests Black individuals have a lower risk of atrial fibrillation (AF) than White individuals, but this may be related to the underdetection of AF. Whether this trend persists using highly sensitive methods of AF diagnosis has not been well-studied.

Objectives

The objective of this study was to use cardiac implantable electronic devices (CIEDs) capable of AF diagnosis to compare AF incidence between Black and White individuals.

Methods

This was a retrospective observational study involving Black and White patients who had a CIED implanted between January 1, 2007, and June 1, 2019. Patients with insertable cardiac monitors, insufficient monitoring, or prior AF were excluded. The primary endpoint was the overall adjusted incidence of device-detected AF between Black and White individuals.

Results

Of 441,047 patients with a CIED implanted during the study period, 88,427 patients (mean age, 69 ± 13 years; 80,382 White [91%]; 55,840 male [63%]) were included in analysis. The mean follow-up duration was 2.2 ± 1.7 years, and 35,143 patients (40%) had device-detected AF. The crude incidence of AF was greater among White, compared with Black, individuals (27.95 vs 24.86 cases per 100 person-years, P < 0.001). After adjusting for age, sex, and medical comorbidities, the hazard of AF was similar between Black and White individuals (HR: 1.02; 95% CI: 0.98-1.06). In subgroup analysis by type of CIED, White individuals had a greater hazard of AF in the pacemaker cohort, whereas Black individuals had a greater hazard of AF in the implantable cardioverter defibrillator cohort.

Conclusions

The adjusted hazard of AF was similar between Black and White individuals with CIEDs.

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器械检测心房颤动事件的种族差异。

背景：先前的研究表明，黑人患房颤（AF）的风险低于白人，但这可能与房颤的检测不足有关。使用高灵敏度的房颤诊断方法是否会持续这种趋势尚未得到充分研究。目的：本研究的目的是使用能够诊断AF的心脏植入式电子装置（CIEDs）来比较黑人和白人之间的AF发病率。方法：这是一项回顾性观察研究，涉及2007年1月1日至2019年6月1日期间植入CIED的黑人和白人患者。排除了可插入心脏监护仪、监测不充分或有房颤病史的患者。主要终点是黑人和白人之间装置检测到的房颤的总体调整发生率。结果：在研究期间植入CIED的441,047例患者中，88,427例患者(平均年龄69±13岁；White [91%] 80,382；55,840例男性（63%）纳入分析。平均随访时间为2.2±1.7年，35,143例患者（40%）患有器械检测到的房颤。与黑人相比，白人房颤的粗发生率更高（27.95例/ 100人年vs 24.86例/ 100人年，P < 0.001）。在调整了年龄、性别和医疗合并症后，黑人和白人之间的房颤风险相似(HR, 1.02；95% ci: 0.98-1.06)。在按CIED类型进行的亚组分析中，白人在起搏器组中发生房颤的风险更高，而黑人在植入式心律转复除颤器组中发生房颤的风险更高。结论：黑人和白人cied患者AF的校正危险相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JACC. Clinical electrophysiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

10.30

自引率

5.70%

发文量

250

期刊介绍： JACC: Clinical Electrophysiology is one of a family of specialist journals launched by the renowned Journal of the American College of Cardiology (JACC). It encompasses all aspects of the epidemiology, pathogenesis, diagnosis and treatment of cardiac arrhythmias. Submissions of original research and state-of-the-art reviews from cardiology, cardiovascular surgery, neurology, outcomes research, and related fields are encouraged. Experimental and preclinical work that directly relates to diagnostic or therapeutic interventions are also encouraged. In general, case reports will not be considered for publication.