Blacks with atrial fibrillation have higher rate of complications than whites

Black individuals with atrial fibrillation (AF) had an approximately 1.5- to 2-fold greater risk of stroke, heart failure, coronary heart disease, and all-cause mortality compared to white individuals with the arrhythmia, according to a study published online by JAMA Cardiology.

Jared W. Magnani, MD, MSc, formerly of the Boston University School of Medicine, and colleagues examined race-specific associations of atrial fibrillation with stroke, heart failure, coronary heart disease (CHD), and all-cause mortality among more than 15,000 individuals. For this analysis, the researchers used data from the Atherosclerosis Risk in Communities (ARIC) Study, which from 1987 through 1989 enrolled 15,792 men and women and conducted four follow-up examinations (2011-2013) with active surveillance for vital status and hospitalizations. Race was determined by self-report and categorized as white, black, or other.

After exclusions, 15,080 participants (average age, 54 years; 56% women; 25% black individuals) were included in this analysis. During an average follow-up of 21 years, there were 2,348 cases of incident AF. There was a higher incidence of AF in white individuals compared with black individuals. Both white and black individuals with AF had markedly increased risks of the outcomes of stroke, heart failure, CHD, and all-cause mortality.

"Our results contribute toward understanding the significant racial differences in black and white individuals with AF. Further study must now address the mechanisms for such differences to improve treatment of AF and prevent complications. Likewise, continued investigation of the causes and origins for such racial differences may identify racial disparities and suggest approaches to address and mitigate them," the authors wrote. -by Rebecca Zumoff