Incidence of and risk factors for sick sinus syndrome in the general population

Little is known about the incidence of and risk factors for sick sinus syndrome (SSS), a common indication for pacemaker implantation. This study sought to describe the epidemiology of SSS. This analysis included 20,572 participants (mean baseline age 59 years, 43% male) in the ARIC (Atherosclerosis...

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Veröffentlicht in:Journal of the American College of Cardiology Jg. 64; H. 6; S. 531
Hauptverfasser: Jensen, Paul N, Gronroos, Noelle N, Chen, Lin Y, Folsom, Aaron R, deFilippi, Chris, Heckbert, Susan R, Alonso, Alvaro
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 12.08.2014
Schlagworte:
Aged
Aged, 80 and over
Black People - ethnology
Cohort Studies
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Population Surveillance - methods
Prospective Studies
Risk Factors
Sick Sinus Syndrome - diagnosis
Sick Sinus Syndrome - epidemiology
Sick Sinus Syndrome - ethnology
White People - ethnology
epidemiology
tachy-brady syndrome
pacemaker
sick sinus syndrome
ISSN:1558-3597, 1558-3597
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Zusammenfassung:Little is known about the incidence of and risk factors for sick sinus syndrome (SSS), a common indication for pacemaker implantation. This study sought to describe the epidemiology of SSS. This analysis included 20,572 participants (mean baseline age 59 years, 43% male) in the ARIC (Atherosclerosis Risk In Communities) study and the CHS (Cardiovascular Health Study), who at baseline were free of prevalent atrial fibrillation and pacemaker therapy, had a heart rate of ≥ 50 beats/min unless using beta blockers, and were identified as of white or black race. Incident SSS cases were identified by hospital discharge International Classification of Disease-revision 9-Clinical Modification code 427.81 and validated by medical record review. During an average 17 years of follow-up, 291 incident SSS cases were identified (unadjusted rate 0.8 per 1,000 person-years). Incidence increased with age (hazard ratio [HR]: 1.73; 95% confidence interval [CI]: 1.47 to 2.05 per 5-year increment), and blacks had a 41% lower risk of SSS than whites (HR: 0.59; 95% CI: 0.37 to 0.98). Incident SSS was associated with greater baseline body mass index, height, N-terminal pro-B-type natriuretic peptide, and cystatin C, with longer QRS interval, with lower heart rate, and with prevalent hypertension, right bundle branch block, and cardiovascular disease. We project that the annual number of new SSS cases in the United States will increase from 78,000 in 2012 to 172,000 in 2060. Blacks have a lower risk of SSS than whites, and several cardiovascular risk factors were associated with incident SSS. With the aging of the population, the number of Americans with SSS will increase dramatically over the next 50 years.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1558-3597
1558-3597
DOI:10.1016/j.jacc.2014.03.056