Genetic Predisposition, Clinical Risk Factor Burden, and Lifetime Risk of Atrial Fibrillation

Weng, Lu‐Chen; Preis, Sarah R.; Hulme, Olivia L.; Larson, Martin G.; Choi, Seung Hoan; Wang, Biqi; Trinquart, Ludovic; McManus, David D.; Stærk, Laila; Lin, Honghuang; Lunetta, Kathryn L.; Ellinor, Patrick T.; Benjamin, Emelia J.; Lubitz, Steven A.

doi:10.1161/circulationaha.117.031431

Cited by 213 publications

(164 citation statements)

References 54 publications

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“…For example, the prevalence of diabetes mellitus and MI in the ARIC cohort was higher than that in the Rotterdam Study. 21 Differences in the lifetime risk of AF between the current ARIC report and the recent Framingham Heart Study 6 can be explained by dissimilarities in the ascertainment of AF, which rely mostly in hospitalizations in ARIC, whereas the Framingham Heart Study had access to outpatient medical records. Multiple studies have demonstrated that AAs have lower incidence of AF than whites.…”

Section: Discussionmentioning

confidence: 99%

“…4 Findings from the Framingham Heart Study in 2004 indicated that 1 in 4 individuals would develop AF during their lifetime, 5 with recent estimates in the same cohort suggesting that lifetime risk of AF is >1 in 3. 6 Lifetime risk quantifies the absolute risk of developing a disease of interest before death. It is calculated as the adjusted cumulative incidence of the disease, taking the competing risk of death into account.…”

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confidence: 99%

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Lifetime Risk of Atrial Fibrillation by Race and Socioeconomic Status

Mou

Norby

Chen

et al. 2018

Circ: Arrhythmia and Electrophysiology

175

102

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BACKGROUND:Limited information exists on the lifetime risk of atrial fibrillation (AF) in African Americans and by socioeconomic status. METHODS:We studied 15 343 participants without AF at baseline from the ARIC (Atherosclerosis Risk in Communities) cohort recruited in 1987 to 1989 from 4 communities in the United States when they were 45 to 64 years of age. Participants have been followed through 2014. Incidence rates of AF were calculated dividing the number of new cases by personyears of follow-up. Lifetime risk of AF was estimated by a modified Kaplan-Meier method considering death as a competing risk. Participants' family income and education were obtained at baseline. RESULTS:We identified 2760 AF cases during a mean follow-up of 21 years. Lifetime risk of AF was 36% (95% confidence interval, 32%-38%) in white men, 30% (95% confidence interval, 26%-32%) in white women, 21% (95% confidence interval, 13%-24%) in African American men, and 22% (95% confidence interval, 16%-25%) in African American women. Regardless of race and sex, incidence rates of AF decreased from the lowest to the highest categories of income and education. In contrast, lifetime risk of AF increased in individuals with higher income and education in most sex-race groups. Cumulative incidence of AF was lower in those with higher income and education compared with their low socioeconomic status counterparts through earlier life but was reversed after age 80.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Lifetime Risk of Atrial Fibrillation by Race and Socioeconomic Status

Mou

Norby

Chen

et al. 2018

Circ: Arrhythmia and Electrophysiology

175

102

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“…Ascertainment of AF in the UK Biobank includes samples with one or more of the following codes 1) Non-cancer illness code, self-reported (1471, 1483), 2) Operation code (1524), 3) Diagnoses – main/secondary ICD10 (I48, I48.0–4, I48.9), 4) Underlying (primary/secondary) cause of death: ICD10 (I48, I48.0–4, I48.9) 5) Diagnoses – main/secondary ICD9 (4273), 6) Operative procedures – main/secondary OPCS (K57.1, K62.1–4). 8,10,33 Baseline characteristics for each study are reported in Supplementary Table 17 . We analyzed: 55,114 cases and 482,295 referents of European ancestry, 1,307 cases and 7,660 referents of African American ancestry, 8,180 cases and 28,612 referents of Japanese ancestry, 568 cases and 1,096 referents from Brazil and 277 cases and 3,081 referents of Hispanic ethnicity.…”

Section: Methodsmentioning

confidence: 99%

Multi-ethnic genome-wide association study for atrial fibrillation

et al. 2018

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Atrial fibrillation (AF) affects over 33 million individuals worldwide1 and has a complex heritability.2 We conducted the largest meta-analysis of genome-wide association studies for AF to date, consisting of over half a million individuals including 65,446 with AF. In total, we identified 97 loci significantly associated with AF including 67 of which were novel in a combined-ancestry analysis, and 3 in a European specific analysis. We sought to identify AF-associated genes at the GWAS loci by performing RNA-sequencing and expression quantitative trait loci (eQTL) analyses in 101 left atrial samples, the most relevant tissue for AF. We also performed transcriptome-wide analyses that identified 57 AF-associated genes, 42 of which overlap with GWAS loci. The identified loci implicate genes enriched within cardiac developmental, electrophysiological, contractile and structural pathways. These results extend our understanding of the biological pathways underlying AF and may facilitate the development of therapeutics for AF.

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“…The lifetime risk is 1 in 4 according to previous studies,2, 3 and more than 1 in 3 based on recent data 4. Several risk factors have been identified, many of which are also risk factors for several types of cancer, such as age, smoking, alcohol consumption, and obesity 5, 6.…”

Section: Introductionmentioning

confidence: 97%

Atrial Fibrillation and Risk of Cancer: A Danish Population‐Based Cohort Study

Vinter

Christesen

Fenger‐Grøn

et al. 2018

JAHA

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BackgroundAtrial fibrillation (AF) and cancer are frequent diseases worldwide. The timewise association between the diagnosis of AF and a subsequent diagnosis of cancer may clarify whether a mutual cause exists, and may also guide clinicians about time windows of high risk of cancer occurrence.Methods and ResultsWe conducted a population‐based cohort study among 26 222 men and 28 879 women free of AF and cancer at baseline based on the Danish Diet, Cancer and Health study. The participants were followed for the development of AF (the Danish National Patient Registry) and subsequent cancer (the Danish Cancer Registry) until 2013. We used Cox proportional hazard models with new‐onset AF as time‐dependent exposure. The men (median age 56 years) and women (median age 56 years) were followed for medians of 16.7 and 19.6 years, respectively. AF was associated with higher risks of any type of cancer (men: hazard ratio [HR] 1.41, 95% confidence interval [CI], 1.26–1.58; women: HR 1.15, 95% CI, 1.02–1.32), and for men only, lung (HR 1.66, 95% CI, 1.19–2.30), and colorectal cancer (HR 1.37, 95% CI, 1.02–1.85). Within the initial 90 days following the diagnosis of AF, the risks of any type of cancer (men: HR 2.89, 95% CI, 2.10–3.98; women: HR 3.72, 95% CI, 2.49–5.56), lung (men: HR 7.70, 95% CI, 4.34–13.68; women: HR 7.98, 95% CI, 3.96–16.09), and colorectal cancer (men: HR 3.35, 95% CI, 1.03–10.90; women: HR 5.91, 95% CI, 2.44–14.29) were higher for men and women.ConclusionsA diagnosis of AF is associated with a higher incidence rate of cancer among men and women. The cancer incidence rate is particularly elevated within 90 days after the diagnosis of AF.

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Genetic Predisposition, Clinical Risk Factor Burden, and Lifetime Risk of Atrial Fibrillation

Cited by 213 publications

References 54 publications

Lifetime Risk of Atrial Fibrillation by Race and Socioeconomic Status

Lifetime Risk of Atrial Fibrillation by Race and Socioeconomic Status

Multi-ethnic genome-wide association study for atrial fibrillation

Atrial Fibrillation and Risk of Cancer: A Danish Population‐Based Cohort Study

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