Correlates and consequences of atrial fibrillation in a prospective study of 25 000 participants in the China Kadoorie Biobank
EHJ - Open
Abstract
The prevalence of atrial fibrillation (AF) is positively correlated with prior cardiovascular diseases (CVD) and CVD risk factors but is lower in Chinese than Europeans despite their higher burden of CVD. We examined the prevalence and prognosis of AF and other electrocardiogram (ECG) abnormalities in the China Kadoorie Biobank.
A random sample of 25 239 adults (mean age 59.5 years, 62% women) had a 12-lead ECG recorded and interpreted using a Mortara VERITAS™ algorithm in 2013–14. Participants were followed up for 5 years for incident stroke, ischaemic heart disease, heart failure (HF), and all CVD, overall and by CHA2DS2-VASc scores, age, sex, and area. Overall, 1.2% had AF, 13.6% had left ventricular hypertrophy (LVH), and 28.1% had ischaemia (two-thirds of AF cases also had ischaemia or LVH). The prevalence of AF increased with age, prior CVD, and levels of CHA₂DS₂-VASc scores (0.5%, 1.3%, 2.1%, 2.9%, and 4.4% for scores <2, 2, 3, 4, and ≥5, respectively). Atrial fibrillation was associated with two-fold higher hazard ratios (HR) for CVD (2.15; 95% CI, 1.71–2.69) and stroke (1.88; 1.44–2.47) and a four-fold higher HR for HF (3.79; 2.21–6.49). The 5-year cumulative incidence of CVD was comparable for AF, prior CVD, and CHA₂DS₂-VASc scores ≥ 2 (36.7% vs. 36.2% vs. 37.7%, respectively) but was two-fold greater than for ischaemia (19.4%), LVH (18.0%), or normal ECG (14.1%), respectively.
The findings highlight the importance of screening for AF together with estimation of CHA₂DS₂-VASc scores for prevention of CVD in Chinese adults.
Contributors
Iain Turnbull
Author
Christian Fielder Camm
Author
Jim Halsey
Author
Huaidong Du
Author
Derrick A Bennett
Author
Yiping Chen
Author
Canqing Yu
Author
Dianyianji Sun
Author
Xiaohong Liu
Author
Liming Li
Author
Zhengming Chen
Author
Junshi Chen
Author
Zhengming Chen
Author
Robert Clarke
Author
Rory Collins
Author
Liming Li
Author
Jun Lv
Author
Richard Peto
Author
Robin Walters
Author
Daniel Avery
Author
Derrick Bennett
Author
Ruth Boxall
Author
Ka Hung Chan
Author
Yiping Chen
Author
Zhengming Chen
Author
Charlotte Clarke
Author
Johnathan Clarke
Author
Robert Clarke
Author
Huaidong Du
Author
Geoffrey Ma
Author
Ahmed Edris Mohamed
Author
Hannah Fry
Author
Simon Gilbert
Author
Pek Kei Im
Author
Andri Iona
Author
Maria Kakkoura
Author
Christiana Kartsonaki
Author
Hubert Lam
Author
Kuang Lin
Author
James Liu
Author
Mohsen Mazidi
Author
Iona Millwood
Author
Sam Morris
Author
Qunhua Nie
Author
Alfred Pozarickij
Author
Maryam Rahmati
Author
Paul Ryder
Author
Dan Schmidt
Author
Becky Stevens
Author
Iain Turnbull
Author
Robin Walters
Author
Baihan Wang
Author
Lin Wang
Author
Neil Wright
Author
Ling Yang
Author
Xiaoming Yang
Author
Pang Yao
Author
Xiao Han
Author
Can Hou
Author
Qingmei Xia
Author
Chao Liu
Author
Jun Lv
Author
Pei Pei
Author
Dianjianyi Sun
Author
Canqing Yu
Author
Lang Pan
Author
Naying Chen
Author
Duo Liu
Author
Zhenzhu Tang
Author
Ningyu Chen
Author
Qilian Jiang
Author
Jian Lan
Author
Mingqiang Li
Author
Yun Liu
Author
Fanwen Meng
Author
Jinhuai Meng
Author
Rong Pan
Author
Yulu Qin
Author
Ping Wang
Author
Sisi Wang
Author
Liuping Wei
Author
Liyuan Zhou
Author
Caixia Dong
Author
Pengfei Ge
Author
Xiaolan Ren
Author
Zhongxiao Li
Author
Enke Mao
Author
Tao Wang
Author
Hui Zhang
Author
Xi Zhang
Author
Jinyan Chen
Author
Ximin Hu
Author
Xiaohuan Wang
Author
Zhendong Guo
Author
Huimei Li
Author
Yilei Li
Author
Min Weng
Author
Shukuan Wu
Author
Shichun Yan
Author
Mingyuan Zou
Author
Xue Zhou
Author
Ziyan Guo
Author
Quan Kang
Author
Yanjie Li
Author
Bo Yu
Author
Qinai Xu
Author
Liang Chang
Author
Lei Fan
Author
Shixian Feng
Author
Ding Zhang
Author
Gang Zhou
Author
Yulian Gao
Author
Tianyou He
Author
Pan He
Author
Chen Hu
Author
Huarong Sun
Author
Xukui Zhang
Author
Biyun Chen
Author
Zhongxi Fu
Author
Yuelong Huang
Author
Huilin Liu
Author
Qiaohua Xu
Author
Li Yin
Author
Huajun Long
Author
Xin Xu
Author
Hao Zhang
Author
Libo Zhang
Author
Jian Su
Author
Ran Tao
Author
Ming Wu
Author
Jie Yang
Author
Jinyi Zhou
Author
Yonglin Zhou
Author
Yihe Hu
Author
Yujie Hua
Author
Jianrong Jin
Author
Fang Liu
Author
Jingchao Liu
Author
Yan Lu
Author
Liangcai Ma
Author
Aiyu Tang
Author
Jun Zhang
Author
Liang Cheng
Author
Ranran Du
Author
Ruqin Gao
Author
Feifei Li
Author
Shanpeng Li
Author
Yongmei Liu
Author
Feng Ning
Author
Zengchang Pang
Author
Xiaohui Sun
Author
Xiaocao Tian
Author
Shaojie Wang
Author
Yaoming Zhai
Author
Hua Zhang
Author
Wei Hou
Author
Silu Lv
Author
Junzheng Wang
Author
Xiaofang Chen
Author
Xianping Wu
Author
Ningmei Zhang
Author
Weiwei Zhou
Author
Xiaofang Chen
Author
Jianguo Li
Author
Jiaqiu Liu
Author
Guojin Luo
Author
Qiang Sun
Author
Xunfu Zhong
Author
Weiwei Gong
Author
Ruying Hu
Author
Hao Wang
Author
Meng Wang
Author
Min Yu
Author
Lingli Chen
Author
Qijun Gu
Author
Dongxia Pan
Author
Chunmei Wang
Author
Kaixu Xie
Author
Xiaoyi Zhang
Author
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