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Additional file 3. Summary of SYCT substudy activities. This table includes timing and content of questionnaires.

Additional file 1. Modeling of Estimated Impact of SARS-CoV-2 Self-testing. This figure provides a detailed description of the key assumptions included in the modeling of the estimated impact of at-home SARS-CoV-2 rapid antigen testing on SARS-CoV-2 transmission in candidate communities.

Additional file 2. QuickVue At-Home COVID-19 Test: User Instructions. The instructions for use of the at-home rapid antigen test that were included with the test kits. Reproduced with permission of Quidel Corporation.

Although obesity is an independent risk factor for heart failure (HF), once HF is established, obesity is associated with lower mortality. It is unclear if the weight loss due to advanced HF leads to this paradoxical finding.This study sought to evaluate the prognostic impact of pre-morbid obesity in patients with HF.In the ARIC (Atherosclerosis Risk In Communities) study, we used body mass index (BMI) measured ≥6 months before incident HF (pre-morbid BMI) to evaluate the association of overweight (BMI 25 to30 kg/m(2)) and obesity (BMI ≥30 kg/m(2)) compared with normal BMI (18.5 to25 kg/m(2)) with mortality after incident HF.Among 1,487 patients with incident HF, 35% were overweight and 47% were obese by pre-morbid BMI measured 4.3 ± 3.1 years before HF diagnosis. Over 10-year follow-up after incident HF, 43% of patients died. After adjustment for demographics and comorbidities, being pre-morbidly overweight (hazard ratio [HR]: 0.72; 95% confidence interval [CI]: 0.58 to 0.90; p = 0.004) or obese (HR: 0.70; 95% CI: 0.56 to 0.87; p = 0.001) had a protective association with survival compared with normal BMI. The protective effect of overweight and obesity was consistent across subgroups on the basis of a history of cancer, smoking, and diabetes.Our results, for the first time, demonstrate that patients who were overweight or obese before HF development have lower mortality after HF diagnosis compared with normal BMI patients. Thus, weight loss due to advanced HF may not completely explain the protective effect of higher BMI in HF patients.

Although the incidence of and mortality following ST-segment elevation myocardial infarction (STEMI) is decreasing, time-trends in anatomical location of STEMI and associated short-term prognosis have not been examined in a population-based community study. We determined 22-year trends in age- and race-adjusted, gender-specific incidence rates and 28-day case fatality of hospitalized STEMI by anatomic infarct location among a stratified random sample of 35-74 year old residents of four communities in the Atherosclerosis Risk in Communities (ARIC) study. STEMI infarct location was assessed by 12-lead electrocardiograms (ECG) from the hospital record, and was coded as anterior, inferior, lateral and multi-location STEMI using the Minnesota Code. Between 1987 and 2008, a total of 4,845 patients had an incident STEMI; 37.2% were inferior STEMI; 32.8% were anterior; 16.8% occurred in multiple infarct locations and 13.2% were lateral STEMI. For inferior, anterior and lateral STEMI in both men and women, significant declines were observed in the age-adjusted annual incidence rate and the associated 28-day case fatality. In contrast, for STEMI in multiple infarct locations, neither the annual incidence rate nor the 28-day case fatality changed over time. The age- and race-adjusted annual incidence rate and associated 28-day case fatality of STEMI in anterior, inferior and lateral infarct locations declined over 22 years of surveillance; however, no decline was observed for STEMI in multiple infarct locations. In conclusion, our findings suggest there is room for improvement in the care of patients with multi-location STEMI.

BackgroundAlthough obesity is an independent risk factor for heart failure (HF), once HF is established, obesity is associated with lower mortality. It is unclear if the weight loss due to advanced HF leads to this paradoxical finding.ObjectivesThis study sought to evaluate the prognostic impact of pre-morbid obesity in patients with HF.MethodsIn the ARIC (Atherosclerosis Risk In Communities) study, we used body mass index (BMI) measured ≥6 months before incident HF (pre-morbid BMI) to evaluate the association of overweight (BMI 25 to

Increasingly, epidemiologic studies use administrative data to identify atrial fibrillation (AF). Capture of incident AF is not well documented. We examined incidence rates and concordance of AF diagnosis based on active cohort follow-up versus surveillance of Centers for Medicare and Medicaid Services data in the Atherosclerosis Risk in Communities study.