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

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dc.contributor.authorO'Neal, Wesley T.
dc.contributor.authorEfird, Jimmy T.
dc.contributor.authorNazarian, Saman
dc.contributor.authorAlonso, Alvaro
dc.contributor.authorHeckbert, Susan R.
dc.contributor.authorSoliman, Elsayed Z.
dc.date.accessioned2016-05-31T16:39:42Z
dc.date.available2016-05-31T16:39:42Z
dc.date.issued2014-12
dc.description.abstractBackground 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.en_US
dc.identifier.citationJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease; 3:6 p. 1-7en_US
dc.identifier.doi10.1161/JAHA.114.001270
dc.identifier.issn2047-9980
dc.identifier.pmidpmc4338716en_US
dc.identifier.urihttp://hdl.handle.net/10342/5419
dc.relation.urihttp://jaha.ahajournals.org/content/3/6/e001270.fullen_US
dc.subjectankle‐brachial indexen_US
dc.subjectatrial fibrillationen_US
dc.subjectperipheral arterial diseaseen_US
dc.subjectstrokeen_US
dc.titlePeripheral Arterial Disease and Risk of Atrial Fibrillation and Stroke: The Multi�Ethnic Study of Atherosclerosisen_US
dc.typeArticleen_US
ecu.journal.issue6en_US
ecu.journal.nameJournal of the American Heart Association: Cardiovascular and Cerebrovascular Diseaseen_US
ecu.journal.pages1-7en_US
ecu.journal.volume3en_US

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