Christianson Eleanor, Liu Yingshuo, Dahl Alexander, Tsakiris Eli, Abi-Rached Joe, McGarvey Cecile, Chouman Nour, Bidaoui Ghassan, Assaf Ala, Younes Hadi, Bsoul Mayana, Jia Yishi, Gu Yuxuan, Lim Chanho, Kreidieh Omar, Pandey Amitabh, Rao Swati, Li Xiang, Feng Han, Marrouche Nassir
Tulane Research Innovation for Arrhythmia Discovery, New Orleans, Louisiana, USA.
University of Texas Health Science Center at Houston, Houston, Texas, USA.
JACC Adv. 2025 Aug 28;4(10 Pt 2):102083. doi: 10.1016/j.jacadv.2025.102083.
Extensive research has been done on the connection between dietary habits and cardiovascular health; however, the impact of food desert residence on atrial fibrillation (AF) patients remains unclear.
The aim of this study is to assess the association between food desert residence and ischemic stroke, all-cause hospitalization, and all-cause mortality risk among AF patients.
Using the Research Action for Health Network database and the United States Department of Agriculture's Food Access Research Atlas, AF patients in New Orleans were grouped into AF-inside food desert group and AF-outside food desert groups. Kaplan-Meier curves were used for the comparisons among ischemic stroke, all-cause hospitalization, all-cause mortality, and combined outcome. Multivariable Cox models were developed to adjust for relevant factors.
Among the AF patients living in the New Orleans metropolitan area, 1,115 were identified as part of the AFID group and 438 in the AFOD group. Kaplan-Meier curves presented differences in ischemic stroke, all-cause hospitalization, all-cause mortality, and composite outcomes between the 2 groups. In Cox regression, after controlling for age, biological sex, body mass index, comorbidities, and medications including anticoagulant use, the AFID group experienced a statistically significant higher risk of ischemic stroke (HR: 2.21; 95% CI: 1.12-4.36; P = 0.02), mortality (HR: 3.84; 95% CI: 1.39-10.61; P = 0.01), and composite outcomes including hospitalization, ischemic stroke, and all-cause mortality (HR: 1.42; 95% CI: 1.16-1.74; P < 0.001)) as compared to the AFOD group.
Residence in a food desert was associated with a 2.2-fold increase in stroke risk and a 3.8-fold increase in all-cause mortality among AF patients.
关于饮食习惯与心血管健康之间的联系已开展了大量研究;然而,食物荒漠地区居住情况对心房颤动(AF)患者的影响仍不明确。
本研究旨在评估食物荒漠地区居住情况与AF患者缺血性卒中、全因住院及全因死亡风险之间的关联。
利用健康网络研究行动数据库和美国农业部的食物获取研究地图集,将新奥尔良的AF患者分为食物荒漠地区内的AF组(AFID组)和食物荒漠地区外的AF组(AFOD组)。采用Kaplan-Meier曲线比较缺血性卒中、全因住院、全因死亡及综合结局。建立多变量Cox模型以调整相关因素。
在居住于新奥尔良大都市区的AF患者中,1115例被确定为AFID组,438例为AFOD组。Kaplan-Meier曲线显示两组在缺血性卒中、全因住院、全因死亡及综合结局方面存在差异。在Cox回归分析中,在控制年龄、生物学性别、体重指数、合并症以及包括抗凝药物使用在内的药物因素后,与AFOD组相比,AFID组缺血性卒中风险显著更高(风险比:2.21;95%置信区间:1.12 - 4.36;P = 0.02)、死亡风险(风险比:3.84;95%置信区间:1.39 - 10.61;P = 0.01)以及包括住院、缺血性卒中和全因死亡的综合结局风险(风险比:1.42;95%置信区间:1.16 - 1.74;P < 0.001)。
居住在食物荒漠地区与AF患者卒中风险增加2.2倍及全因死亡风险增加3.8倍相关。