期刊
HEART RHYTHM
卷 13, 期 1, 页码 233-240出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.hrthm.2015.07.031
关键词
Atrial flutter; Atrial fibrillation; Risk factors; Outcomes; Epidemiology
资金
- National Institutes of Health [R03AG045075, K23HL114724, KL2RR031981, NS17950, N01-HC-25195, 6R01-NS17950, 2R01HL092577, HHSN268201500001I, 1R01 HL102214, R01HL104156, K24HL105780]
- Doris Duke Charitable Foundation Clinical Scientist Development Award [2014105]
- American Heart Association Established Investigator Award [13EIA14220013]
- DIVISION OF EPIDEMIOLOGY AND CLINICAL APPLICATIONS [N01HC025195] Funding Source: NIH RePORTER
- NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES [UL1TR001453] Funding Source: NIH RePORTER
- NATIONAL CENTER FOR RESEARCH RESOURCES [KL2RR031981] Funding Source: NIH RePORTER
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [K23HL114724, K24HL105780, R01HL102214, R01HL092577] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE [R01NS017950] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON AGING [R03AG045075, R01AG008122, R01AG054076] Funding Source: NIH RePORTER
BACKGROUND Few epidemiologic cohort studies have evaluated atrial flutter (flutter) as an arrhythmia distinct from atrial fibrillation (AF). OBJECTIVE The purpose of this study was to examine the clinical correlates of flutter and its associated outcomes to distinguish them from those associated with AF in the Framingham Heart Study. METHODS We reviewed and adjudicated electrocardiograms (ECGs) previously classified as flutter or AF/flutter and another 100 ECGs randomly selected from AF cases. We examined the clinical correlates of flutter by matching up to 5 AF and 5 referents to each flutter case using a nested case referent design. We determined the 10-year outcomes associated with flutter with Cox models. RESULTS During mean follow-up of 33.0 +/- 12.2 years, 112 participants (mean age 72 +/- 10 years, 30% women) developed flutter. In multivariable analyses, smoking (odds ratio [OR] 2.84, 95% confidence interval [CI] 1.54-5.23), increased PR interval (OR 1.28 per SD, 95% CI 1.03-1.60), myocardial infarction (OR 2.25, 95% CI 1.05-4.80) and heart failure (OR 5.22, 95% CI 1.26-21.64) were associated with incident flutter. In age- and sex-adjusted models, flutter (vs referents) was associated with 10-year increased risk of AF (hazard ratio [HR] 5.01, 95% CI 3.14-7.99), myocardial infarction (HR 3.05, 95% CI 1.42-6.59), heart failure (HR 4.14, 95% CI 1.90-8.99), stroke (HR 2.17, 95% CI 1.13-4.17), and mortality (HR 2.00, 95% CI 1.44-2.79). CONCLUSION We identified the clinical correlates associated with flutter and observed that flutter was associated with multiple adverse outcomes.
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