Genetic Predisposition, Clinical Risk Factor Burden, and Lifetime Risk of Atrial Fibrillation
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- Lu-Chen Weng
- Cardiovascular Research Center (L.-C.W., O.L.H., P.T.E., S.A.L.)
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- Sarah R. Preis
- Department of Biostatistics, Boston University School of Public Health, MA (S.R.P., M.G.L., B.W., L.T., K.L.L.).
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- Olivia L. Hulme
- Cardiovascular Research Center (L.-C.W., O.L.H., P.T.E., S.A.L.)
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- Martin G. Larson
- Department of Biostatistics, Boston University School of Public Health, MA (S.R.P., M.G.L., B.W., L.T., K.L.L.).
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- Seung Hoan Choi
- Massachusetts General Hospital, Boston. Program in Medical and Population Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (L.-C.W., O.L.H., S.H.C., P.T.E., S.A.L.).
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- Biqi Wang
- Department of Biostatistics, Boston University School of Public Health, MA (S.R.P., M.G.L., B.W., L.T., K.L.L.).
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- Ludovic Trinquart
- Department of Biostatistics, Boston University School of Public Health, MA (S.R.P., M.G.L., B.W., L.T., K.L.L.).
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- David D. McManus
- Department of Medicine, Cardiology Division, University of Massachusetts Medical School, Worcester (D.D.M.).
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- Laila Staerk
- Boston University and National Heart, Lung and Blood Institute’s Framingham Heart Study, MA (S.R.P., M.G.L., L.T., L.S., H.L., K.L.L., E.J.B.).
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- Honghuang Lin
- Boston University and National Heart, Lung and Blood Institute’s Framingham Heart Study, MA (S.R.P., M.G.L., L.T., L.S., H.L., K.L.L., E.J.B.).
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- Kathryn L. Lunetta
- Department of Biostatistics, Boston University School of Public Health, MA (S.R.P., M.G.L., B.W., L.T., K.L.L.).
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- Patrick T. Ellinor
- Cardiovascular Research Center (L.-C.W., O.L.H., P.T.E., S.A.L.)
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- Emelia J. Benjamin
- Boston University and National Heart, Lung and Blood Institute’s Framingham Heart Study, MA (S.R.P., M.G.L., L.T., L.S., H.L., K.L.L., E.J.B.).
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- Steven A. Lubitz
- Cardiovascular Research Center (L.-C.W., O.L.H., P.T.E., S.A.L.)
書誌事項
- 公開日
- 2018-03-06
- DOI
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- 10.1161/circulationaha.117.031431
- 公開者
- Ovid Technologies (Wolters Kluwer Health)
この論文をさがす
説明
<jats:sec> <jats:title>Background:</jats:title> <jats:p>The long-term probability of developing atrial fibrillation (AF) considering genetic predisposition and clinical risk factor burden is unknown.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>We estimated the lifetime risk of AF in individuals from the community-based Framingham Heart Study. Polygenic risk for AF was derived using a score of ≈1000 AF-associated single-nucleotide polymorphisms. Clinical risk factor burden was calculated for each individual using a validated risk score for incident AF comprised of height, weight, systolic and diastolic blood pressure, current smoking status, antihypertensive medication use, diabetes mellitus, history of myocardial infarction, and history of heart failure. We estimated the lifetime risk of AF within tertiles of polygenic and clinical risk.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p> Among 4606 participants without AF at 55 years of age, 580 developed incident AF (median follow-up, 9.4 years; 25th–75th percentile, 4.4–14.3 years). The lifetime risk of AF >55 years of age was 37.1% and was substantially influenced by both polygenic and clinical risk factor burden. Among individuals free of AF at 55 years of age, those in low-polygenic and clinical risk tertiles had a lifetime risk of AF of 22.3% (95% confidence interval, 15.4−9.1), whereas those in high-risk tertiles had a risk of 48.2% (95% confidence interval, 41.3−55.1). A lower clinical risk factor burden was associated with later AF onset after adjusting for genetic predisposition ( <jats:italic>P</jats:italic> <0.001). </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>In our community-based cohort, the lifetime risk of AF was 37%. Estimation of polygenic AF risk is feasible and together with clinical risk factor burden explains a substantial gradient in long-term AF risk.</jats:p> </jats:sec>
収録刊行物
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- Circulation
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Circulation 137 (10), 1027-1038, 2018-03-06
Ovid Technologies (Wolters Kluwer Health)