Racial differences in atrial fibrillation-related strokes and mortality

Abstract Funding Acknowledgements Type of funding sources: None. Background and Aims Adverse outcomes associated with atrial fibrillation (AF) in Asians have not been fully elucidated. In a patient-level comparative analysis of UK Biobank and Korean National Health Insurance Service-Health Screening data, we evaluated the race-specific associations of AF with stroke and mortality. Methods This study enrolled 425,805 Asians (mean [SD] age, 56.0 [9.3] years; 55.3% of men) and 372,851 Whites (mean [SD] age, 57.1 [8.0] years; 47.6% of men). The main outcomes were total, ischemic, and hemorrhagic strokes and all-cause death. Results During the follow-up period (mean [SD], 7.3 [1.4] years in Asians; 11.7 [1.5] years in Whites), the incident rates (IR) of AF per 1000 person-years were 2.6 (95% CI, 2.5–2.7) in Asians and 4.4 (95% CI, 4.3–4.5) in Whites. The IR of total, ischemic, and hemorrhagic strokes were greater in Asians with AF than in Whites with AF. The rate difference (IR of the outcome in those with AF minus IR of the outcome in those without AF) for total stroke was 15.2 (95% CI, 13.4–17.0) in Asians and 4.5 (95% CI, 4.0–5.0) in Whites. For ischemic and hemorrhagic strokes, the rate differences were 2.5- to 3.5-fold higher in Asians than in Whites. Asians had a rate difference of 26.3 (95% CI, 24.2–28.4) for all-cause death, whereas Whites had a rate difference of 20.7 (95% CI, 19.7–21.7). Conclusion Despite the higher incidence of AF in Whites, the outcomes of AF-related rates of total, ischemic, and hemorrhagic strokes and all-cause death was greater in Asians than Whites.