{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:28:59Z","timestamp":1790083739330,"version":"4.0.1"},"reference-count":30,"publisher":"BMJ","issue":"23","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"accepted":{"date-parts":[[2010,9,21]]},"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Little is known about the incidence and clinical characteristics of newly diagnosed atrial fibrillation\/flutter (AF) in urban Africans in epidemiological transition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This observational cohort study was carried out in the Chris Hani Baragwanath Hospital in Soweto South Africa. A clinical registry captured detailed clinical data on all de novo cases of AF presenting to the Cardiology Unit during the period 2006\u20132008.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 246 of 5328 cardiac cases (4.6%) presented with AF (estimated 5.6 cases\/100\u2008000 population\/annum). Mean age was 59\u00b118\u2005years and the majority were of African descent (n=211, 86%) and\/or female (n=150, 61%). Men were more than twice as likely to smoke (OR 2.88, 95% CI 1.92 to 4.04) than women, but women were twice as likely to be obese (OR 1.80, 95% CI 1.28 to 2.52) than men. Lone AF occurred in 22 (8.9%) cases, while concurrent valve disease and\/or functional valvular abnormality occurred in 107 cases (44%). Overall, 171 cases (70%) presented with uncontrolled AF (ventricular rate &gt;90 beats\/min) with no sex-based differences. Common co-morbidities were any form of heart failure (56%) and rheumatic heart disease (21%). Women with AF were more likely to present with hypertensive heart failure (OR 2.37, 95% CI 1.24 to 4.54) but less likely to present with a dilated cardiomyopathy (OR 0.42, 95% CI 0.23 to 0.76) or coronary artery disease (OR 0.38, 95% CI 0.14 to 1.02) than men. Mean overall CHADS<jats:sub>2<\/jats:sub> score (in 195 non-rheumatic cases) was 1.51\u00b10.91 and, despite a similar age profile, women had higher scores than men (1.73\u00b10.94 vs 1.24\u00b10.78; p&lt;0.0001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These unique data suggest that urban Africans in Soweto develop AF at a relatively young age. Conventional strategies used to manage and treat AF need to be carefully evaluated in this setting.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/hrt.2010.206938","type":"journal-article","created":{"date-parts":[[2010,11,9]],"date-time":"2010-11-09T09:43:09Z","timestamp":1289295789000},"page":"1878-1882","source":"Crossref","is-referenced-by-count":59,"title":["Predisposing factors and incidence of newly diagnosed atrial fibrillation in an urban African community: insights from the Heart of Soweto Study"],"prefix":"10.1136","volume":"96","author":[{"given":"Karen","family":"Sliwa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda Jane","family":"Carrington","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Klug","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lionel","family":"Opie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldine","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocasta","family":"Ball","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2010,11,9]]},"reference":[{"key":"2025101800571584000_96.23.1878.1","doi-asserted-by":"publisher","DOI":"10.1136\/heart.86.5.516"},{"key":"2025101800571584000_96.23.1878.2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2003.014720"},{"key":"2025101800571584000_96.23.1878.3","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2000.2511"},{"key":"2025101800571584000_96.23.1878.4","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.107573"},{"key":"2025101800571584000_96.23.1878.5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03510350050036"},{"key":"2025101800571584000_96.23.1878.6","first-page":"237","article-title":"Racial differences in the prevalence of atrial fibrillation among males","volume":"100","author":"Borzecki","year":"2008","journal-title":"J Natl Med Assoc"},{"key":"2025101800571584000_96.23.1878.7","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.573907"},{"key":"2025101800571584000_96.23.1878.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60417-1"},{"key":"2025101800571584000_96.23.1878.9","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp530"},{"key":"2025101800571584000_96.23.1878.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2007.11.067"},{"key":"2025101800571584000_96.23.1878.11","unstructured":"Prineas R Crow R Blackburn H . 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