Po-01-137 racial differences in atrial fibrillation-related ischemic and hemorrhagic strokes and mortality. a patient-level comparative analysis of uk biobank and korean nationwide data

Adverse outcomes associated with atrial fibrillation (AF) in Asians have not yet been fully elucidated, although reported event rates from Asia appear higher than non-Asians. In a patient-level comparative analysis of two national cohort data, we evaluated the race-specific associations of AF with stroke and mortality. The Korean National Health Insurance Service-Health Screening and UK Biobank are prospective, observational cohorts. From 2005 through 2012, follow-up health examinations were conducted regularly. The main outcomes were total, ischemic, and hemorrhagic strokes and all-cause death. 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). 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 (difference in IR of the outcome between those with and 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. Consistently, the identical trend was observed for all-cause death In the K-NHIS-HealS and UK Biobank Study, the outcomes of AF-related rates of total, ischemic, and hemorrhagic strokes and all-cause death was greater in Asians than Whites. Despite the higher incidence of AF in Whites, there was a much poorer prognosis in Asians with AF.