Atrial fibrillation in Indigenous and non-Indigenous Australians: A cross-sectional study

Christopher X. Wong, Anthony G. Brooks, Yi Han Cheng, Dennis H. Lau, Geetanjali Rangnekar, Kurt C. Roberts-Thomson, Jonathan M. Kalman, Alex Brown, Prashanthan Sanders

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: To examine the prevalence of atrial fibrillation (AF) and cardiac structural characteristics in Indigenous and non-Indigenous Australians. Design: Retrospective cross-sectional study linking clinical, echocardiography and administrative databases over a 10-year period. Setting: A tertiary, university teaching hospital in Adelaide, Australia. Participants: Indigenous and non-Indigenous Australians. Main outcome measures: AF prevalence and echocardiographic characteristics. Results: Indigenous Australians with AF were significantly younger compared to non-Indigenous Australians (55±13 vs 75±13 years, p<0.001). As a result, racial differences in AF prevalence and left atrial diameter varied according to age. In those under 60 years of age, Indigenous Australians had a significantly greater AF prevalence (2.57 vs1.73%, p<0.001) and left atrial diameters (39±7 vs 37±7 mm, p<0.001) compared to non-Indigenous Australians. In those aged 60 years and above, however, non- Indigenous Australians had significantly greater AF prevalence (9.26 vs 4.61%, p<0.001) and left atrial diameters (39±7 vs 37±7 mm, p<0.001). Left ventricular ejection fractions were less in Indigenous Australians under 60 years of age (49±14 vs 55±11%, p<0.001) and not statistically different in those aged 60 years and above (47±11 vs 52±13, p=0.074) compared to non-Indigenous Australians. Despite their younger age, Indigenous Australians with AF had similar or greater rates of cardiovascular comorbidities than non-Indigenous Australians with AF. Conclusions: Young Indigenous Australians have a significantly greater prevalence of AF than their non-Indigenous counterparts. In contrast, older non-Indigenous Australians have a greater prevalence of AF compared to their Indigenous counterparts. These observations may be mediated by age-based differences in comorbid cardiovascular conditions, left atrial diameter and left ventricular ejection fraction. Our findings suggest that AF is likely to be contributing to the greater burden of morbidity and mortality experienced by young Indigenous Australians. Further study is required to elucidate whether strategies to prevent and better manage AF in Indigenous Australians may reduce this burden.

LanguageEnglish
Article numbere006242
JournalBMJ open
Volume4
Issue number10
DOIs
Publication statusPublished - 1 Jan 2014

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Wong, C. X., Brooks, A. G., Cheng, Y. H., Lau, D. H., Rangnekar, G., Roberts-Thomson, K. C., ... Sanders, P. (2014). Atrial fibrillation in Indigenous and non-Indigenous Australians: A cross-sectional study. BMJ open, 4(10), [e006242]. https://doi.org/10.1136/bmjopen-2014-006242
Wong, Christopher X. ; Brooks, Anthony G. ; Cheng, Yi Han ; Lau, Dennis H. ; Rangnekar, Geetanjali ; Roberts-Thomson, Kurt C. ; Kalman, Jonathan M. ; Brown, Alex ; Sanders, Prashanthan. / Atrial fibrillation in Indigenous and non-Indigenous Australians : A cross-sectional study. In: BMJ open. 2014 ; Vol. 4, No. 10.
@article{f94fb87cfabc4480bf388a6385930c3e,
title = "Atrial fibrillation in Indigenous and non-Indigenous Australians: A cross-sectional study",
abstract = "Objective: To examine the prevalence of atrial fibrillation (AF) and cardiac structural characteristics in Indigenous and non-Indigenous Australians. Design: Retrospective cross-sectional study linking clinical, echocardiography and administrative databases over a 10-year period. Setting: A tertiary, university teaching hospital in Adelaide, Australia. Participants: Indigenous and non-Indigenous Australians. Main outcome measures: AF prevalence and echocardiographic characteristics. Results: Indigenous Australians with AF were significantly younger compared to non-Indigenous Australians (55±13 vs 75±13 years, p<0.001). As a result, racial differences in AF prevalence and left atrial diameter varied according to age. In those under 60 years of age, Indigenous Australians had a significantly greater AF prevalence (2.57 vs1.73{\%}, p<0.001) and left atrial diameters (39±7 vs 37±7 mm, p<0.001) compared to non-Indigenous Australians. In those aged 60 years and above, however, non- Indigenous Australians had significantly greater AF prevalence (9.26 vs 4.61{\%}, p<0.001) and left atrial diameters (39±7 vs 37±7 mm, p<0.001). Left ventricular ejection fractions were less in Indigenous Australians under 60 years of age (49±14 vs 55±11{\%}, p<0.001) and not statistically different in those aged 60 years and above (47±11 vs 52±13, p=0.074) compared to non-Indigenous Australians. Despite their younger age, Indigenous Australians with AF had similar or greater rates of cardiovascular comorbidities than non-Indigenous Australians with AF. Conclusions: Young Indigenous Australians have a significantly greater prevalence of AF than their non-Indigenous counterparts. In contrast, older non-Indigenous Australians have a greater prevalence of AF compared to their Indigenous counterparts. These observations may be mediated by age-based differences in comorbid cardiovascular conditions, left atrial diameter and left ventricular ejection fraction. Our findings suggest that AF is likely to be contributing to the greater burden of morbidity and mortality experienced by young Indigenous Australians. Further study is required to elucidate whether strategies to prevent and better manage AF in Indigenous Australians may reduce this burden.",
author = "Wong, {Christopher X.} and Brooks, {Anthony G.} and Cheng, {Yi Han} and Lau, {Dennis H.} and Geetanjali Rangnekar and Roberts-Thomson, {Kurt C.} and Kalman, {Jonathan M.} and Alex Brown and Prashanthan Sanders",
year = "2014",
month = "1",
day = "1",
doi = "10.1136/bmjopen-2014-006242",
language = "English",
volume = "4",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "10",

}

Wong, CX, Brooks, AG, Cheng, YH, Lau, DH, Rangnekar, G, Roberts-Thomson, KC, Kalman, JM, Brown, A & Sanders, P 2014, 'Atrial fibrillation in Indigenous and non-Indigenous Australians: A cross-sectional study', BMJ open, vol. 4, no. 10, e006242. https://doi.org/10.1136/bmjopen-2014-006242

Atrial fibrillation in Indigenous and non-Indigenous Australians : A cross-sectional study. / Wong, Christopher X.; Brooks, Anthony G.; Cheng, Yi Han; Lau, Dennis H.; Rangnekar, Geetanjali; Roberts-Thomson, Kurt C.; Kalman, Jonathan M.; Brown, Alex; Sanders, Prashanthan.

In: BMJ open, Vol. 4, No. 10, e006242, 01.01.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Atrial fibrillation in Indigenous and non-Indigenous Australians

T2 - BMJ Open

AU - Wong, Christopher X.

AU - Brooks, Anthony G.

AU - Cheng, Yi Han

AU - Lau, Dennis H.

AU - Rangnekar, Geetanjali

AU - Roberts-Thomson, Kurt C.

AU - Kalman, Jonathan M.

AU - Brown, Alex

AU - Sanders, Prashanthan

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objective: To examine the prevalence of atrial fibrillation (AF) and cardiac structural characteristics in Indigenous and non-Indigenous Australians. Design: Retrospective cross-sectional study linking clinical, echocardiography and administrative databases over a 10-year period. Setting: A tertiary, university teaching hospital in Adelaide, Australia. Participants: Indigenous and non-Indigenous Australians. Main outcome measures: AF prevalence and echocardiographic characteristics. Results: Indigenous Australians with AF were significantly younger compared to non-Indigenous Australians (55±13 vs 75±13 years, p<0.001). As a result, racial differences in AF prevalence and left atrial diameter varied according to age. In those under 60 years of age, Indigenous Australians had a significantly greater AF prevalence (2.57 vs1.73%, p<0.001) and left atrial diameters (39±7 vs 37±7 mm, p<0.001) compared to non-Indigenous Australians. In those aged 60 years and above, however, non- Indigenous Australians had significantly greater AF prevalence (9.26 vs 4.61%, p<0.001) and left atrial diameters (39±7 vs 37±7 mm, p<0.001). Left ventricular ejection fractions were less in Indigenous Australians under 60 years of age (49±14 vs 55±11%, p<0.001) and not statistically different in those aged 60 years and above (47±11 vs 52±13, p=0.074) compared to non-Indigenous Australians. Despite their younger age, Indigenous Australians with AF had similar or greater rates of cardiovascular comorbidities than non-Indigenous Australians with AF. Conclusions: Young Indigenous Australians have a significantly greater prevalence of AF than their non-Indigenous counterparts. In contrast, older non-Indigenous Australians have a greater prevalence of AF compared to their Indigenous counterparts. These observations may be mediated by age-based differences in comorbid cardiovascular conditions, left atrial diameter and left ventricular ejection fraction. Our findings suggest that AF is likely to be contributing to the greater burden of morbidity and mortality experienced by young Indigenous Australians. Further study is required to elucidate whether strategies to prevent and better manage AF in Indigenous Australians may reduce this burden.

AB - Objective: To examine the prevalence of atrial fibrillation (AF) and cardiac structural characteristics in Indigenous and non-Indigenous Australians. Design: Retrospective cross-sectional study linking clinical, echocardiography and administrative databases over a 10-year period. Setting: A tertiary, university teaching hospital in Adelaide, Australia. Participants: Indigenous and non-Indigenous Australians. Main outcome measures: AF prevalence and echocardiographic characteristics. Results: Indigenous Australians with AF were significantly younger compared to non-Indigenous Australians (55±13 vs 75±13 years, p<0.001). As a result, racial differences in AF prevalence and left atrial diameter varied according to age. In those under 60 years of age, Indigenous Australians had a significantly greater AF prevalence (2.57 vs1.73%, p<0.001) and left atrial diameters (39±7 vs 37±7 mm, p<0.001) compared to non-Indigenous Australians. In those aged 60 years and above, however, non- Indigenous Australians had significantly greater AF prevalence (9.26 vs 4.61%, p<0.001) and left atrial diameters (39±7 vs 37±7 mm, p<0.001). Left ventricular ejection fractions were less in Indigenous Australians under 60 years of age (49±14 vs 55±11%, p<0.001) and not statistically different in those aged 60 years and above (47±11 vs 52±13, p=0.074) compared to non-Indigenous Australians. Despite their younger age, Indigenous Australians with AF had similar or greater rates of cardiovascular comorbidities than non-Indigenous Australians with AF. Conclusions: Young Indigenous Australians have a significantly greater prevalence of AF than their non-Indigenous counterparts. In contrast, older non-Indigenous Australians have a greater prevalence of AF compared to their Indigenous counterparts. These observations may be mediated by age-based differences in comorbid cardiovascular conditions, left atrial diameter and left ventricular ejection fraction. Our findings suggest that AF is likely to be contributing to the greater burden of morbidity and mortality experienced by young Indigenous Australians. Further study is required to elucidate whether strategies to prevent and better manage AF in Indigenous Australians may reduce this burden.

UR - http://www.scopus.com/inward/record.url?scp=84911425671&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2014-006242

DO - 10.1136/bmjopen-2014-006242

M3 - Article

VL - 4

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 10

M1 - e006242

ER -

Wong CX, Brooks AG, Cheng YH, Lau DH, Rangnekar G, Roberts-Thomson KC et al. Atrial fibrillation in Indigenous and non-Indigenous Australians: A cross-sectional study. BMJ open. 2014 Jan 1;4(10). e006242. https://doi.org/10.1136/bmjopen-2014-006242