Key result
Male sex linked to ~120% higher 13-year risk of incident AF.
Why the study?
AF is the most common arrhythmia and a predictor of ASCVD complications, motivating the analysis of determinants of incident AF risk in a Russian middle- and elderly-aged cohort.
What are the determinants of incident atrial fibrillation over 13 years in a middle-aged and elderly Russian population free of baseline cardiovascular disease?
Cohort (n=3,871)
No
What are the determinants of incident atrial fibrillation over 13 years in a middle-aged and elderly Russian population free of baseline cardiovascular disease?
Effect estimate: HR 2.20 (95% CI 1.26-3.87)
In a Russian population cohort, incident atrial fibrillation over 13 years was positively associated with male sex, age, BMI, and systolic blood pressure, and negatively associated with total cholesterol.
These associations may inform AF risk assessment in similar cohorts but should not yet change practice; extends determinants to a Russian population while leaving causality open.
Atrial fibrillation (AF) is the most common arrhythmia and a predictor of the complications of atherosclerotic cardiovascular diseases (ASCVDs), particularly thromboembolic events and the progression of heart failure. We analyzed the determinants of the 13-year risk of incident AF in a Russian population cohort of middle and elderly age. A random population sample (n = 9360, age 45–69 years) was examined at baseline in 2003–2005 and reexamined in 2006–2008 and 2015–2017 in Novosibirsk (the HAPIEE study). Incident AF was being registered during the average follow-up of 13 years. The final analysis included 3871 participants free from baseline AF and cardiovascular disease (CVD) who participated in all three data collections. In a multivariable-adjusted Cox regression model, the 13-year risk of AF was positively associated with the male sex (hazard ratio (HR) = 2.20; 95% confidence interval (CI) 1.26–3.87); age (HR = 1.10 per year; 95% CI 1.07–1.14); body mass index (BMI), (HR = 1.11 per unit; 95% CI 1.07–1.15); systolic blood pressure (SBP), (HR = 1.02 per 1 mmHg; 95% CI 1.01–1.02), and it was negatively associated with total cholesterol (TC), (HR = 0.79 per 1 mmol/L; 95% CI 0.66–0.94). In women, the risk of AF was more strongly associated with hypertension (HT) and was also negatively related to total cholesterol (TC) level (HR = 0.74 per 1 mmol/L; 95% CI 0.56–0.96). No independent association was found with mean alcohol intake per drinking occasion. These results in a Russian cohort have an implication for the prediction of AF and ASCVD complications in the general population.
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Shapkina et al. (2022) conducted a cohort in Incident Atrial Fibrillation (n=3,871). Risk factors (male sex, age, BMI, SBP, TC) was evaluated on 13-year risk of incident atrial fibrillation (HR 2.20, 95% CI 1.26-3.87). Male sex (HR 2.20; 95% CI 1.26-3.87), age, BMI, and systolic blood pressure increased the 13-year risk of incident atrial fibrillation, whereas total cholesterol decreased the risk.
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