Key result
High fitness in obese, non-athletic adults is linked to ~79% higher risk of new-onset AF.
Why the study?
Data on the association between atrial fibrillation and fitness are conflicting, prompting an investigation into how fitness and obesity relate to incident AF in apparently healthy non-athlete adults.
Does high fitness increase the risk of new-onset atrial fibrillation in apparently healthy non-athlete adults?
Cohort (n=20,410)
No
Does high fitness increase the risk of new-onset atrial fibrillation in apparently healthy non-athlete adults?
Effect estimate: HR 1.79 (95% CI 1.15-2.78)
Absolute Event Rate: 0.55% vs 0.31%
p-value: p=0.01
High fitness levels may paradoxically increase the risk of new-onset atrial fibrillation in obese, non-athletic adults.
High fitness may increase AF risk in obese non-athletes; hypothesis-generating and requires prospective validation before clinical consideration.
Background Data on the association between AF and fitness are conflicting. Objectives The aim of this analysis was to investigate the association between fitness, obesity and incidence of atrial fibrillation (AF) among apparently healthy non-athlete adults. Methods We investigated 20 410 self-referred subjects who were annually screened in a tertiary medical centre. All subjects were free of AF and completed maximal exercise stress test according to the Bruce protocol at baseline. Fitness was categorised into age- and sex-specific quintiles (Q) according to the treadmill time. Subjects were categorised to low (Q1-Q2) and high fitness (Q3-5) groups. The primary end point was new-onset AF during follow-up. Results Mean age was 48 ± 10 years and 72% were men. A total of 463 (2.3%) events occurred during an average follow-up of 8 ± 5 years corresponding to an AF event rate of 0.3% per person year. Univariate and multivariate models showed that AF risk was similar in both fitness groups. However, AF event rate was 0.55% per person year among high fitness obese subjects, compared with 0.31% for low fitness obese subjects (P < .01). Subgroup interaction analysis showed that AF risk is obesity-dependent, such that in the obese group (≥30 kg/m2) high fitness was independently associated with a significant 79% increased AF risk (95% CI 1.15-2.78; P = .01), whereas among non-obese subjects the rate of events was similar between both fitness groups (P for interaction = (.02)). Conclusions Our findings suggest that high fitness might be associated with increased AF risk among obese subjects.
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Younis et al. (2020) conducted a cohort in Apparently healthy non-athlete adults (n=20,410). High fitness (Quintiles 3-5) vs. Low fitness (Quintiles 1-2) was evaluated on New-onset atrial fibrillation (HR 1.79, 95% CI 1.15-2.78, p=0.01). High fitness in obese, non-athletic adults was associated with a 79% increased risk of new-onset atrial fibrillation compared to low fitness (95% CI 1.15-2.78; P=0.01).
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