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    Peripheral Arterial Disease and Risk of Atrial Fibrillation and Stroke: The Multi�Ethnic Study of Atherosclerosis

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    Author
    O'Neal, Wesley T.; Efird, Jimmy T.; Nazarian, Saman; Alonso, Alvaro; Heckbert, Susan R.; Soliman, Elsayed Z.
    Abstract
    Background Peripheral arterial disease (PAD) shares several risk factors with atrial fibrillation (AF), and persons with PAD have an increased risk of stroke. It is unclear if PAD is associated with an increased risk for AF and whether this potential association explains the increased risk of stroke observed in those with PAD. Methods and Results We examined the association between PAD, measured by ankle‐brachial index (ABI), and incident AF and incident stroke, separately, in 6568 participants (mean age 62±10 years, 53% women, 62% nonwhite) from the Multi‐Ethnic Study of Atherosclerosis (MESA). ABI values <1.0 or >1.4 defined PAD. AF was ascertained through review of hospital discharge records and from Medicare claims data until December 31, 2010. An independent adjudication committee ascertained stroke events. Cox regression was used to estimate hazard ratios and 95% CIs for the association between PAD and AF and stroke. Over a median follow‐up of 8.5 years, 301 (4.6%) participants developed AF and 140 (2.1%) developed stroke. In a model adjusted for sociodemographics, cardiovascular risk factors, and potential confounders, PAD was associated with an increased risk of AF (hazard ratio 1.5, 95% CI 1.1 to 2.0). In a similar model, PAD was associated with incident stroke (hazard ratio 1.7, 95% CI 1.1 to 2.5), and the magnitude of risk was not different after inclusion of AF as a time‐dependent covariate (hazard ratio 1.7, 95% CI 1.1 to 2.5). Conclusions PAD is associated with an increased risk of AF and stroke in MESA. Potentially, the relationship between PAD and stroke is not mediated by AF.
    URI
    http://hdl.handle.net/10342/5419
    Subject
     ankle‐brachial index; atrial fibrillation; peripheral arterial disease; stroke 
    Date
    2014-12
    Citation:
    APA:
    O'Neal, Wesley T., & Efird, Jimmy T., & Nazarian, Saman, & Alonso, Alvaro, & Heckbert, Susan R., & Soliman, Elsayed Z.. (December 2014). Peripheral Arterial Disease and Risk of Atrial Fibrillation and Stroke: The Multi�Ethnic Study of Atherosclerosis. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, (3:6), p.1-7. Retrieved from http://hdl.handle.net/10342/5419

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    MLA:
    O'Neal, Wesley T., and Efird, Jimmy T., and Nazarian, Saman, and Alonso, Alvaro, and Heckbert, Susan R., and Soliman, Elsayed Z.. "Peripheral Arterial Disease and Risk of Atrial Fibrillation and Stroke: The Multi�Ethnic Study of Atherosclerosis". Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease. 3:6. (1-7.), December 2014. April 21, 2021. http://hdl.handle.net/10342/5419.
    Chicago:
    O'Neal, Wesley T. and Efird, Jimmy T. and Nazarian, Saman and Alonso, Alvaro and Heckbert, Susan R. and Soliman, Elsayed Z., "Peripheral Arterial Disease and Risk of Atrial Fibrillation and Stroke: The Multiâ€?Ethnic Study of Atherosclerosis," Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease 3, no. 6 (December 2014), http://hdl.handle.net/10342/5419 (accessed April 21, 2021).
    AMA:
    O'Neal, Wesley T., Efird, Jimmy T., Nazarian, Saman, Alonso, Alvaro, Heckbert, Susan R., Soliman, Elsayed Z.. Peripheral Arterial Disease and Risk of Atrial Fibrillation and Stroke: The Multi�Ethnic Study of Atherosclerosis. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease. December 2014; 3(6) 1-7. http://hdl.handle.net/10342/5419. Accessed April 21, 2021.
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