Risk Factors Influencing Outcomes of Atrial Fibrillation in ALLHAT

ALLHAT, a randomized, double-blind, active-controlled, multicenter clinical trial of high risk hypertensive participants, compared treatment with an ACE-inhibitor (lisinopril) or calcium channel blocker (amlodipine) with a diuretic (chlorthalidone). Primary outcome was the occurrence of fatal corona...

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Veröffentlicht in:Journal of the National Medical Association 2018-08, Vol.110 (4), p.343-351
Hauptverfasser: Haywood, L. Julian, Davis, Barry R., Piller, Linda B., Simpson, Lara M., Ghosh, Alokananda, Einhorn, Paula T., Ford, Charles E., Probstfield, Jeffrey L., Soliman, Elsayed Z., Wright, Jackson T.
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container_end_page 351
container_issue 4
container_start_page 343
container_title Journal of the National Medical Association
container_volume 110
creator Haywood, L. Julian
Davis, Barry R.
Piller, Linda B.
Simpson, Lara M.
Ghosh, Alokananda
Einhorn, Paula T.
Ford, Charles E.
Probstfield, Jeffrey L.
Soliman, Elsayed Z.
Wright, Jackson T.
description ALLHAT, a randomized, double-blind, active-controlled, multicenter clinical trial of high risk hypertensive participants, compared treatment with an ACE-inhibitor (lisinopril) or calcium channel blocker (amlodipine) with a diuretic (chlorthalidone). Primary outcome was the occurrence of fatal coronary heart disease or nonfatal myocardial infarction. For this report, post-hoc analyses were conducted to determine the contribution of baseline characteristics of participants with or without baseline or incident atrial fibrillation (AF) and atrial flutter (AFL) to stroke, heart failure (HF), coronary heart disease (CHD), and mortality outcomes. Minnesota Coding of baseline and biennial in-trial ECGs was used to determine the 334 baseline and 537 incident AF/AFL cases, respectively participants with AF/AFL: Cox regression was used to estimate hazard ratios of presence versus absence of either baseline or incident AF/AFL (as time-dependent covariate) for occurrence of stroke, CHD, HF, or mortality, while adjusting for selected baseline characteristics. Adjusted Cox regression was used to obtain hazard ratios (HRs) for presence versus absence of selected baseline characteristics among those with and without either baseline or incident AF/AFL. After adjusting for baseline characteristics, baseline AF/AFL was associated with stroke, HF, and mortality (HRs [95% CIs] 3.18, [2.34–4.33]; 2.65 [2.02–3.49]; and 2.10 [CI, 1.73–2.55], respectively, P 
doi_str_mv 10.1016/j.jnma.2017.07.003
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Julian ; Davis, Barry R. ; Piller, Linda B. ; Simpson, Lara M. ; Ghosh, Alokananda ; Einhorn, Paula T. ; Ford, Charles E. ; Probstfield, Jeffrey L. ; Soliman, Elsayed Z. ; Wright, Jackson T.</creator><creatorcontrib>Haywood, L. Julian ; Davis, Barry R. ; Piller, Linda B. ; Simpson, Lara M. ; Ghosh, Alokananda ; Einhorn, Paula T. ; Ford, Charles E. ; Probstfield, Jeffrey L. ; Soliman, Elsayed Z. ; Wright, Jackson T. ; ALLHAT Collaborative Research Group</creatorcontrib><description>ALLHAT, a randomized, double-blind, active-controlled, multicenter clinical trial of high risk hypertensive participants, compared treatment with an ACE-inhibitor (lisinopril) or calcium channel blocker (amlodipine) with a diuretic (chlorthalidone). Primary outcome was the occurrence of fatal coronary heart disease or nonfatal myocardial infarction. For this report, post-hoc analyses were conducted to determine the contribution of baseline characteristics of participants with or without baseline or incident atrial fibrillation (AF) and atrial flutter (AFL) to stroke, heart failure (HF), coronary heart disease (CHD), and mortality outcomes. Minnesota Coding of baseline and biennial in-trial ECGs was used to determine the 334 baseline and 537 incident AF/AFL cases, respectively participants with AF/AFL: Cox regression was used to estimate hazard ratios of presence versus absence of either baseline or incident AF/AFL (as time-dependent covariate) for occurrence of stroke, CHD, HF, or mortality, while adjusting for selected baseline characteristics. Adjusted Cox regression was used to obtain hazard ratios (HRs) for presence versus absence of selected baseline characteristics among those with and without either baseline or incident AF/AFL. After adjusting for baseline characteristics, baseline AF/AFL was associated with stroke, HF, and mortality (HRs [95% CIs] 3.18, [2.34–4.33]; 2.65 [2.02–3.49]; and 2.10 [CI, 1.73–2.55], respectively, P &lt; 0.05). Incident AF/AFL was a significant risk factor for HF and mortality (HRs 2.80 and 2.06, respectively, P &lt; 0.05). Risk factor profiles for clinical outcomes for those with and without baseline or incident AF/AFL were largely similar. AF/AFL is a significant risk factor for stroke, HF, and mortality. Additional risk factors for these outcomes were generally similar for participants with and without baseline or incident AF/AFL.</description><identifier>ISSN: 0027-9684</identifier><identifier>EISSN: 1943-4693</identifier><identifier>DOI: 10.1016/j.jnma.2017.07.003</identifier><identifier>PMID: 30126559</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age ; Atrial fibrillation ; Body mass index ; Cardiac arrhythmia ; Cardiovascular disease ; Diabetes ; Diuretics ; Double-blind studies ; Fatal CHD ; Health risk assessment ; Heart attacks ; Heart failure ; Hypertension ; Mortality ; Risk factors ; Stroke</subject><ispartof>Journal of the National Medical Association, 2018-08, Vol.110 (4), p.343-351</ispartof><rights>2017 National Medical Association</rights><rights>Copyright © 2017 National Medical Association. All rights reserved.</rights><rights>Copyright Elsevier Limited Aug 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-103b7493e4c49f858c3219bb63ffe0387b000a76c17a37f565d55f39a354049c3</citedby><cites>FETCH-LOGICAL-c483t-103b7493e4c49f858c3219bb63ffe0387b000a76c17a37f565d55f39a354049c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30126559$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Haywood, L. Julian</creatorcontrib><creatorcontrib>Davis, Barry R.</creatorcontrib><creatorcontrib>Piller, Linda B.</creatorcontrib><creatorcontrib>Simpson, Lara M.</creatorcontrib><creatorcontrib>Ghosh, Alokananda</creatorcontrib><creatorcontrib>Einhorn, Paula T.</creatorcontrib><creatorcontrib>Ford, Charles E.</creatorcontrib><creatorcontrib>Probstfield, Jeffrey L.</creatorcontrib><creatorcontrib>Soliman, Elsayed Z.</creatorcontrib><creatorcontrib>Wright, Jackson T.</creatorcontrib><creatorcontrib>ALLHAT Collaborative Research Group</creatorcontrib><title>Risk Factors Influencing Outcomes of Atrial Fibrillation in ALLHAT</title><title>Journal of the National Medical Association</title><addtitle>J Natl Med Assoc</addtitle><description>ALLHAT, a randomized, double-blind, active-controlled, multicenter clinical trial of high risk hypertensive participants, compared treatment with an ACE-inhibitor (lisinopril) or calcium channel blocker (amlodipine) with a diuretic (chlorthalidone). Primary outcome was the occurrence of fatal coronary heart disease or nonfatal myocardial infarction. For this report, post-hoc analyses were conducted to determine the contribution of baseline characteristics of participants with or without baseline or incident atrial fibrillation (AF) and atrial flutter (AFL) to stroke, heart failure (HF), coronary heart disease (CHD), and mortality outcomes. Minnesota Coding of baseline and biennial in-trial ECGs was used to determine the 334 baseline and 537 incident AF/AFL cases, respectively participants with AF/AFL: Cox regression was used to estimate hazard ratios of presence versus absence of either baseline or incident AF/AFL (as time-dependent covariate) for occurrence of stroke, CHD, HF, or mortality, while adjusting for selected baseline characteristics. 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Julian</au><au>Davis, Barry R.</au><au>Piller, Linda B.</au><au>Simpson, Lara M.</au><au>Ghosh, Alokananda</au><au>Einhorn, Paula T.</au><au>Ford, Charles E.</au><au>Probstfield, Jeffrey L.</au><au>Soliman, Elsayed Z.</au><au>Wright, Jackson T.</au><aucorp>ALLHAT Collaborative Research Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factors Influencing Outcomes of Atrial Fibrillation in ALLHAT</atitle><jtitle>Journal of the National Medical Association</jtitle><addtitle>J Natl Med Assoc</addtitle><date>2018-08-01</date><risdate>2018</risdate><volume>110</volume><issue>4</issue><spage>343</spage><epage>351</epage><pages>343-351</pages><issn>0027-9684</issn><eissn>1943-4693</eissn><abstract>ALLHAT, a randomized, double-blind, active-controlled, multicenter clinical trial of high risk hypertensive participants, compared treatment with an ACE-inhibitor (lisinopril) or calcium channel blocker (amlodipine) with a diuretic (chlorthalidone). Primary outcome was the occurrence of fatal coronary heart disease or nonfatal myocardial infarction. For this report, post-hoc analyses were conducted to determine the contribution of baseline characteristics of participants with or without baseline or incident atrial fibrillation (AF) and atrial flutter (AFL) to stroke, heart failure (HF), coronary heart disease (CHD), and mortality outcomes. Minnesota Coding of baseline and biennial in-trial ECGs was used to determine the 334 baseline and 537 incident AF/AFL cases, respectively participants with AF/AFL: Cox regression was used to estimate hazard ratios of presence versus absence of either baseline or incident AF/AFL (as time-dependent covariate) for occurrence of stroke, CHD, HF, or mortality, while adjusting for selected baseline characteristics. Adjusted Cox regression was used to obtain hazard ratios (HRs) for presence versus absence of selected baseline characteristics among those with and without either baseline or incident AF/AFL. After adjusting for baseline characteristics, baseline AF/AFL was associated with stroke, HF, and mortality (HRs [95% CIs] 3.18, [2.34–4.33]; 2.65 [2.02–3.49]; and 2.10 [CI, 1.73–2.55], respectively, P &lt; 0.05). Incident AF/AFL was a significant risk factor for HF and mortality (HRs 2.80 and 2.06, respectively, P &lt; 0.05). Risk factor profiles for clinical outcomes for those with and without baseline or incident AF/AFL were largely similar. AF/AFL is a significant risk factor for stroke, HF, and mortality. Additional risk factors for these outcomes were generally similar for participants with and without baseline or incident AF/AFL.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30126559</pmid><doi>10.1016/j.jnma.2017.07.003</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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subjects Age
Atrial fibrillation
Body mass index
Cardiac arrhythmia
Cardiovascular disease
Diabetes
Diuretics
Double-blind studies
Fatal CHD
Health risk assessment
Heart attacks
Heart failure
Hypertension
Mortality
Risk factors
Stroke
title Risk Factors Influencing Outcomes of Atrial Fibrillation in ALLHAT
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