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. 2022 Mar 16;17(3):e0265498.
doi: 10.1371/journal.pone.0265498. eCollection 2022.

Epidemiology of atrial fibrillation in the All of Us Research Program

Alvaro Alonso  1 , Aniqa B Alam  1 , Hooman Kamel  2 , Vignesh Subbian  3 , Jun Qian  4 , Eric Boerwinkle  5 , Mine Cicek  6 , Cheryl R Clark  7 , Elizabeth G Cohn  8 , Kelly A Gebo  9 , Roxana Loperena-Cortes  10 , Kelsey R Mayo  10 , Stephen Mockrin  11 , Lucila Ohno-Machado  12 , Sheri D Schully  13 , Andrea H Ramirez  14 , Philip Greenland  15
Affiliations

Epidemiology of atrial fibrillation in the All of Us Research Program

Alvaro Alonso et al. PLoS One. .

Abstract

Background: The prevalence, incidence and risk factors of atrial fibrillation (AF) in a large, geographically and ethnically diverse cohort in the United States have not been fully described.

Methods: We analyzed data from 173,099 participants of the All of Us Research Program recruited in the period 2017-2019, with 92,318 of them having electronic health records (EHR) data available, and 35,483 having completed a medical history survey. Presence of AF at baseline was identified from self-report and EHR records. Incident AF was obtained from EHR. Demographic, anthropometric and clinical risk factors were obtained from questionnaires, baseline physical measurements and EHR.

Results: At enrollment, mean age was 52 years old (range 18-89). Females and males accounted for 61% and 39% respectively. Non-Hispanic Whites accounted for 67% of participants, with non-Hispanic Blacks, non-Hispanic Asians and Hispanics accounting for 26%, 4% and 3% of participants, respectively. Among 92,318 participants with available EHR data, 3,885 (4.2%) had AF at the time of study enrollment, while the corresponding figure among 35,483 with medical history data was 2,084 (5.9%). During a median follow-up of 16 months, 354 new cases of AF were identified among 88,433 eligible participants. Individuals who were older, male, non-Hispanic white, had higher body mass index, or a prior history of heart failure or coronary heart disease had higher prevalence and incidence of AF.

Conclusion: The epidemiology of AF in the All of Us Research Program is similar to that reported in smaller studies with careful phenotyping, highlighting the value of this new resource for the study of AF and, potentially, other cardiovascular diseases.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flowchart of study participants, All of Us Research Program, 2017–2019.
EHR: Electronic health records. NHA: Non-Hispanic Asian. NHB: Non-Hispanic Black. NHW: Non-Hispanic White.
Fig 2
Fig 2. Venn diagram representing overlap of participants with EHR data, medical history survey data, those with AF in the EHR, and those with self-reported AF in the medical history survey, All of Us Research Program, 2017–2019.
The intersection of these variables leads to eight different groups: (1) among participants with both EHR and medical survey, those with AF in the EHR and the medical survey (n = 717), AF in the medical survey but no in the EHR (n = 561), AF in the EHR but not in the medical survey (n = 208), and no AF in any data source (n = 19,197); (2) among participants with EHR but not medical survey, AF in the EHR (n = 3,314) and no AF (n = 68,322); and (3) among participants with medical history survey but not EHR, AF in the medical survey (n = 806) and no AF (n = 13,994). The diagram does not include 65,982 participants with neither EHR nor medical history survey.
See this image and copyright information in PMC

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