Evidence map›Paper›PMID 28267478›Full record

ArticleAmerican heart journal2017

Multimorbidity and the risk of hospitalization and death in atrial fibrillation: A population-based study.

Alanna M Chamberlain, Alvaro Alonso, Bernard J Gersh, Sheila M Manemann, Jill M Killian, Susan A Weston, Margaret Byrne, Véronique L Roger

Abstract read
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In one paragraph

Article in American heart journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
71citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

71 citing papers in PubMed, 8 syntheses or guidelines pooled it.

  1. Pooled it
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  4. Guideline
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  9. Association between comorbidity burden and outcomes of catheter ablation vs. medical therapy for atrial fibrillation: insights from the CABANA trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
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  16. Multimorbidity in Atrial Fibrillation: Impact on Outcomes.Journal of the American Heart Association · 2026
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  18. Review
  19. Observational
  20. Article

11 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alanna M ChamberlainDepartment of Health Sciences Research, Mayo Clinic, Rochester, MN. Electronic address: chamberlain.alanna@mayo.edu.
Alvaro AlonsoDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
Bernard J GershDepartment of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
Sheila M ManemannDepartment of Health Sciences Research, Mayo Clinic, Rochester, MN.
Jill M KillianDepartment of Health Sciences Research, Mayo Clinic, Rochester, MN.
Susan A WestonDepartment of Health Sciences Research, Mayo Clinic, Rochester, MN.
Margaret ByrneCorner Home Medical, New Hope, MN.
Véronique L RogerDepartment of Health Sciences Research, Mayo Clinic, Rochester, MN; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.

Funding

Rochester Epidemiology ProjectR01AG034676 · NIA · MAYO CLINIC ROCHESTER · PI ROCCA, WALTER A, ST SAUVER, JENNIFER LYNN · 2010 to 2019
$9.5M
ROCHESTER EPIDEMIOLOGY PROJECTR01AR030582 · NIAMS · MAYO CLINIC ROCHESTER · PI ROCCA, WALTER A · 1986 to 2009
$5.1M
American Heart Association-American Stroke Association 16EIA26410001NIAMS NIH HHS R01 AR030582NIA NIH HHS R01 AG034676
6 · The paper itself

Abstract

Patients with atrial fibrillation (AF) have many comorbidities and excess risks of hospitalization and death. Whether the impact of comorbidities on outcomes is greater in AF than the general population is unknown.

methodsOne thousand four hundred thirty patients with AF and community controls matched 1:1 on age and sex were obtained from Olmsted County, Minnesota. Andersen-Gill and Cox regression estimated associations of 19 comorbidities with hospitalization and death, respectively.

resultsAF cases had a higher prevalence of most comorbidities. Hypertension (25.4%), coronary artery disease (17.7%), and heart failure (13.3%) had the largest attributable risk of AF; these along with obesity and smoking explained 51.4% of AF. Over a mean follow-up of 6.3 years, patients with AF experienced higher rates of hospitalization and death than did population controls. However, the impact of comorbidities on hospitalization and death was generally not greater in patients with AF compared with controls, with the exception of smoking. Ever smokers with AF experienced higher-than-expected risks of hospitalization and death, with observed vs expected (assuming additivity of effects) hazard ratios compared with never smokers without AF of 1.78 (1.56-2.02) vs 1.52 for hospitalization and 2.41 (2.02-2.87) vs 1.84 for death.

conclusionsPatients with AF have a higher prevalence of most comorbidities; however, the impact of comorbidities on hospitalization and death is generally similar in AF and controls. Smoking is a notable exception; ever smokers with AF experienced higher-than-expected risks of hospitalization and death. Thus, interventions targeting modifiable behaviors may benefit patients with AF by reducing their risk of adverse outcomes.

Indexed as

MortalityAgedAged, 80 and overArthritisAsthmaAtrial FibrillationCause of DeathComorbidityCoronary Artery DiseaseDementiaDiabetes MellitusFemaleHeart FailureHospitalizationHumansHyperlipidemias

Identifiers

PMID28267478
PMCPMC5343767

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.