Non-genetic risk factors for atrial fibrillation are equally important in both young and old age: A nationwide population-based study

Abstract

Aims There are several non-genetic risk factors for new-onset atrial fibrillation, including age, sex, obesity, hypertension, diabetes, and alcohol consumption. However, whether these non-genetic risk factors have equal significance among different age groups is not known. We performed a nationwide population-based analysis to compare the clinical significance of non-genetic risk factors for new-onset atrial fibrillation in various age groups. Methods and results A total of 9,797,409 people without a prior diagnosis of atrial fibrillation who underwent a national health check-up in 2009 were included. During 80,130,090 person-years of follow-up, a total of 196,136 people were diagnosed with new-onset atrial fibrillation. The impact of non-genetic risk factors on new-onset atrial fibrillation was examined in different age groups. Obesity, male sex, heavy alcohol consumption, smoking, hypertension, diabetes and chronic kidney disease were associated with an increased risk of new-onset atrial fibrillation. With minor variations, these risk factors were consistently associated with the risk of new-onset atrial fibrillation among various age groups. Using these risk factors, we created a scoring system to predict future risk of new-onset atrial fibrillation in different age groups. In receiver operating characteristic curve analysis, the predictive value of these risk factors ranged between 0.556 and 0.603, and no significant trends were observed. Conclusions Non-genetic risk factors for new-onset atrial fibrillation may have a similar impact on different age groups. Except for sex, these non-genetic risk factors can be modifiable. Therefore, efforts to control non-genetic risk factors might have relevance for both the young and old.

Age-specific atrial fibrillation incidence, attributable risk factors and risk of stroke and mortality: results from the MORGAM Consortium

“…In the present study, several modifiable risk factors such as BMI, previous MI or stroke, hypertension and alcohol consumption were associated with increased risk of AF, the first two consistently in all age groups. These observations are largely in agreement with a study of 10 million individuals in a national Korean health insurance database, 29 which showed that modifiable risk factors such as BMI, high alcohol intake, and hypertension increased the risk of AF in all age groups.…”

Premature ventricular contraction is associated with increased risk of atrial fibrillation: a nationwide population-based study

“…Reduced left ventricular function and subsequent increase in left atrial pressure can also contribute to increased risk of new-onset AF in people with. We have previously reported the impact of hypertension and diabetes on new-onset AF is more profound in young people as compared to the old 20 . Similarly, pronounced impact of PVC on new-onset AF and ischemic stroke in young people is another important finding of our study.…”

Atrial fibrillation is associated with increased risk of lethal ventricular arrhythmias

“…First, there might be inaccuracies in coding, missing data, and selection bias since this was a retrospective study based on data stored in a nationwide health insurance organization. However, our strategy to identify various diseases such as AF, stroke, heart failure, hypertension, or diabetes mellitus has been validated in multiple prior studies 13 , 14 , 35 , 36 . Second, our study was exclusively based on an East Asian population, and caution is needed when applying our results to other ethnic groups.…”