Comparison of Frequency of Atrial Fibrillation in Blacks Versus Whites and the Utilization of Race in a Novel Risk Score

• Published in: The American journal of cardiology 2020-11, Vol.135, p.68-76
• Main Authors: Kowlgi, Gurukripa N., Gunda, Sampath, Padala, Santosh K., Koneru, Jayanthi N., Deshmukh, Abhishek J., Ellenbogen, Kenneth A.
• Format: Article
• Language: English
• Subjects: African Americans - statistics & numerical data; Age; Aged; Atrial Fibrillation - epidemiology; Audio frequencies; Cardiac arrhythmia; Cardiovascular disease; Codes; Cohort Studies; Collaboration; Complications; Congestive heart failure; Coronary vessels; Diabetes; Diabetes mellitus; Ethnicity; European Continental Ancestry Group - statistics & numerical data; Female; Fibrillation; Heart surgery; Hospitals; Humans; Hypertension; Male; Minority & ethnic groups; Patients; Population studies; Prevalence; Regression analysis; Renal failure; Risk analysis; Risk Assessment; Risk Factors; Stroke; United States - epidemiology; Vascular diseases; White people
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2020.08.029

•Atrial fibrillation (AF) is less prevalent in African-Americans than in Caucasians•African-Americans have more AF risk factors than Caucasians•The above disparity is referred to as the AF ethnic paradox•Genetic, autonomic, and socio-economic factors contribute to the AF ethnic paradox•CHADSAVES risk score can help predicting inpatient AF Blacks have a lower prevalence of atrial fibrillation (AF) compared with Whites. We sought to confirm previously reported ethnic trends in AF in Blacks and Whites in a large database, and develop a prediction score for AF. Over 330 million hospital discharges between the years 2003 to 2013 from the National Inpatient Sample database were analyzed. All hospitalizations with a diagnosis of AF formed the study cohort. Traditional risk factors for the development of AF were compared between Blacks and Whites. Univariate and multiple logistic regression analyses were used to formulate a risk score to predict AF–CHADSAVES (Congestive heart failure, Hypertension, Age>65 years, Diabetes Mellitus, prior Stroke, Age>75 years, Vascular disease, White Ethnicity, and previous cardiothoracic Surgery). AF prevalence in Whites was 11.3% vs 4.6% in Blacks (p < 0.001). Blacks were younger (33.8% vs 14.4% patients 2-fold lower prevalence of AF compared with Whites. CHADSAVES can be used effectively to predict AF in inpatients.