{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:26:13Z","timestamp":1753889173806,"version":"3.41.2"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>To investigate the association between family history of atrial fibrillation (AF) with cardiovascular events (CVEs), major adverse cardiac events (MACE), and cardiovascular mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Multicenter prospective observational cohort study including 1722 nonvalvular AF patients from February 2008 to August 2019 in Italy. Family history of AF was defined as the presence of AF in a first-degree relative: mother, father, sibling, or children. Primary outcome was a composite of CVEs including fatal\/nonfatal ischemic stroke and myocardial infarction, and cardiovascular death. Second, we analyzed the association with major adverse cardiac event.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Mean age was 74.6\u00b19.4 years; 44% of women. Family history of AF was detected in 368 (21.4%) patients, and 3.5% had \u22652 relatives affected by AF. Age of AF onset progressively decreased from patients without family history of AF, compared with those with single and multiple first-degree affected relatives (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). During a mean follow-up of 23.7 months (4606 patients\/y) 145 CVEs (3.15%\/y), 98 major adverse cardiac event (2.13%\/y), and 57 cardiovascular deaths (0.97%\/y) occurred. After adjustment for cardiovascular risk factors, family history of AF was associated with a higher risk of CVEs (hazard ratio, 1.524 [95% CI, 1.021\u20132.274],\n              <jats:italic>P<\/jats:italic>\n              =0.039), major adverse cardiac event (hazard ratio, 1.917 [95% CI, 1.207\u20133.045],\n              <jats:italic>P<\/jats:italic>\n              =0.006), and cardiovascular mortality (hazard ratio, 2.008 [95% CI, 1.047\u20133.851],\n              <jats:italic>P<\/jats:italic>\n              =0.036). Subgroup analysis showed that this association was modified by age, sex, and prior ischemic heart disease.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In a cohort of elderly patients with a high atherosclerotic burden, family history of AF is evident in &gt;20% of patients and was associated with an increased risk for CVEs and mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT01882114.\n            <\/jats:p>\n          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Catanzaro, Italy (A.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6610-7068","authenticated-orcid":true,"given":"Francesco","family":"Violi","sequence":"additional","affiliation":[{"name":"I Clinica Medica, Atherothrombosis Center, Department of Clinical, Internal Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.P., D.M., F.V., P.P.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2265-7455","authenticated-orcid":true,"given":"Pasquale","family":"Pignatelli","sequence":"additional","affiliation":[{"name":"I Clinica Medica, Atherothrombosis Center, Department of Clinical, Internal Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.P., D.M., F.V., 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