Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA 98195, USA.
Ann Epidemiol. 2011 Oct;21(10):732-8. doi: 10.1016/j.annepidem.2011.06.003. Epub 2011 Jul 27.
Recent evidence suggests early-life factors correlate with atrial fibrillation (AF). We hypothesized that AF-related mortality, similar to stroke mortality, is elevated for individuals born in the southeastern United States.
We estimated 3-year (1999-2001) average AF-related mortality rates by using U.S. vital statistics for 55- to 89-year-old white (136,573 AF-related deaths) and black subjects (8,288 AF-related deaths). We estimated age- and sex-adjusted odds of AF-related (contributing cause) mortality associated with birth state, and birth within the U.S. stroke belt (SB), stratified by race. SB results were replicated with the use of 1989-1991 data.
Among black subjects, four contiguous birth states were associated with statistically significant odds ratios ≥ 1.25 compared with the national average AF-related mortality. The four highest-risk birth states for blacks also predicted elevated AF-related mortality among white subjects, but patterns were attenuated. The odds ratio for AF-related mortality associated with SB birth was 1.19 (confidence interval 1.13-1.25) for black and 1.09 (CI 1.07-1.12) for white subjects when we adjusted for SB adult residence.
Place of birth predicted AF-related mortality, after we adjusted for place of adult residence. The association of AF-related mortality and SB birth parallels that of other cardiovascular diseases and may likewise indicate an importance of early life factors in the development of AF.
最近的证据表明，生命早期的因素与心房颤动（AF）有关。我们假设，与 AF 相关的死亡率与中风死亡率相似，对于出生在美国东南部的人来说，这一死亡率会升高。
我们使用美国 1999 年至 2001 年的人口统计数据，估计了 55 至 89 岁白人（136573 例与 AF 相关的死亡）和黑人（8288 例与 AF 相关的死亡）的 3 年（1999-2001 年）平均与 AF 相关的死亡率。我们估计了与出生州和出生在美国中风带（SB）相关的与 AF 相关的（主要死因）死亡率的年龄和性别调整比值，按种族分层。使用 1989 年至 1991 年的数据复制了 SB 结果。
在黑人中，与全国平均 AF 相关死亡率相比，四个连续的出生州与统计学上显著的比值比≥1.25相关。对于黑人来说，四个风险最高的出生州也预示着白人的 AF 相关死亡率升高，但模式减弱。对于与 SB 出生相关的 AF 相关死亡率的比值比为 1.19（置信区间 1.13-1.25），对于黑人，当我们调整 SB 成年居住时，比值比为 1.09（CI 1.07-1.12）。
在调整了成年居住地点后，出生地预测了与 AF 相关的死亡率。与 AF 相关的死亡率与 SB 出生之间的关联与其他心血管疾病的关联相似，这可能同样表明早期生活因素在 AF 的发展中的重要性。
