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 |
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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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fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6108439</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S002796841730161X</els_id><sourcerecordid>2188188708</sourcerecordid><originalsourceid>FETCH-LOGICAL-c483t-103b7493e4c49f858c3219bb63ffe0387b000a76c17a37f565d55f39a354049c3</originalsourceid><addsrcrecordid>eNp9kV9rFDEUxYModlv9Aj7IgC--zHrzb5KACNvi2sJCQepzyGSTmnEmqclMwW9vlm2L-iAcyEN-93DPPQi9wbDGgLsPw3qIk1kTwGINVUCfoRVWjLasU_Q5WgEQ0apOshN0WsoAAFJx_hKdUMCk41yt0PnXUH40W2PnlEtzFf24uGhDvG2ul9mmyZUm-WYz52DGZhv6HMbRzCHFJsRms9tdbm5eoRfejMW9fnjP0Lft55uLy3Z3_eXqYrNrLZN0bjHQXjBFHbNMecmlpQSrvu-o9w6oFH3dz4jOYmGo8Lzje849VYZyBkxZeoY-HX3vln5ye-vinM2o73KYTP6lkwn6758YvuvbdK87DJJRVQ3ePxjk9HNxZdZTKNbVQNGlpWgCChMGhIuKvvsHHdKSY42nCZaySoCsFDlSNqdSsvNPy2DQh4r0oA8V6UNFGqqA1qG3f8Z4GnnspAIfj4Crx7wPLutiQy3F7UN2dtb7FP7n_xspfKCN</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2188188708</pqid></control><display><type>article</type><title>Risk Factors Influencing Outcomes of Atrial Fibrillation in ALLHAT</title><source>Alma/SFX Local Collection</source><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.</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 < 0.05). Incident AF/AFL was a significant risk factor for HF and mortality (HRs 2.80 and 2.06, respectively, P < 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. 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 < 0.05). Incident AF/AFL was a significant risk factor for HF and mortality (HRs 2.80 and 2.06, respectively, P < 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><subject>Age</subject><subject>Atrial fibrillation</subject><subject>Body mass index</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular disease</subject><subject>Diabetes</subject><subject>Diuretics</subject><subject>Double-blind studies</subject><subject>Fatal CHD</subject><subject>Health risk assessment</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Hypertension</subject><subject>Mortality</subject><subject>Risk factors</subject><subject>Stroke</subject><issn>0027-9684</issn><issn>1943-4693</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kV9rFDEUxYModlv9Aj7IgC--zHrzb5KACNvi2sJCQepzyGSTmnEmqclMwW9vlm2L-iAcyEN-93DPPQi9wbDGgLsPw3qIk1kTwGINVUCfoRVWjLasU_Q5WgEQ0apOshN0WsoAAFJx_hKdUMCk41yt0PnXUH40W2PnlEtzFf24uGhDvG2ul9mmyZUm-WYz52DGZhv6HMbRzCHFJsRms9tdbm5eoRfejMW9fnjP0Lft55uLy3Z3_eXqYrNrLZN0bjHQXjBFHbNMecmlpQSrvu-o9w6oFH3dz4jOYmGo8Lzje849VYZyBkxZeoY-HX3vln5ye-vinM2o73KYTP6lkwn6758YvuvbdK87DJJRVQ3ePxjk9HNxZdZTKNbVQNGlpWgCChMGhIuKvvsHHdKSY42nCZaySoCsFDlSNqdSsvNPy2DQh4r0oA8V6UNFGqqA1qG3f8Z4GnnspAIfj4Crx7wPLutiQy3F7UN2dtb7FP7n_xspfKCN</recordid><startdate>20180801</startdate><enddate>20180801</enddate><creator>Haywood, L. Julian</creator><creator>Davis, Barry R.</creator><creator>Piller, Linda B.</creator><creator>Simpson, Lara M.</creator><creator>Ghosh, Alokananda</creator><creator>Einhorn, Paula T.</creator><creator>Ford, Charles E.</creator><creator>Probstfield, Jeffrey L.</creator><creator>Soliman, Elsayed Z.</creator><creator>Wright, Jackson T.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180801</creationdate><title>Risk Factors Influencing Outcomes of Atrial Fibrillation in ALLHAT</title><author>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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-103b7493e4c49f858c3219bb63ffe0387b000a76c17a37f565d55f39a354049c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Age</topic><topic>Atrial fibrillation</topic><topic>Body mass index</topic><topic>Cardiac arrhythmia</topic><topic>Cardiovascular disease</topic><topic>Diabetes</topic><topic>Diuretics</topic><topic>Double-blind studies</topic><topic>Fatal CHD</topic><topic>Health risk assessment</topic><topic>Heart attacks</topic><topic>Heart failure</topic><topic>Hypertension</topic><topic>Mortality</topic><topic>Risk factors</topic><topic>Stroke</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><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><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the National Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Haywood, L. 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 < 0.05). Incident AF/AFL was a significant risk factor for HF and mortality (HRs 2.80 and 2.06, respectively, P < 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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