Key result
Physician-diagnosed sleep apnea was associated with a higher risk of incident atrial fibrillation compared to unaffected participants (HR 1.76; 95% CI 1.03-3.02), whereas habitual snoring was not.
Why the study?
Does physician-diagnosed sleep apnea or habitual snoring increase the risk of incident atrial fibrillation in a multiethnic adult population free of baseline cardiovascular disease?
Cohort (n=4,395)
Does physician-diagnosed sleep apnea or habitual snoring increase the risk of incident atrial fibrillation in a multiethnic adult population free of baseline cardiovascular disease?
Effect estimate: HR 1.76 (95% CI 1.03-3.02)
Physician-diagnosed sleep apnea, but not simple habitual snoring, is associated with a significantly increased risk of incident atrial fibrillation in a multiethnic cohort.
May inform AF risk stratification; extends prior associations but remains hypothesis-generating without randomized data.
The association between sleep apnea and atrial fibrillation (AF) has not been examined in a multiethnic adult population in prospective community-based studies. We prospectively (2000-2011) investigated the associations of physician-diagnosed sleep apnea (PDSA), which is considered more severe sleep apnea, and self-reported habitual snoring without PDSA (HS), a surrogate for mild sleep apnea, with incident AF in white, black, and Hispanic participants in the Multi-Ethnic Study of Atherosclerosis (MESA) who were free of clinical cardiovascular disease at baseline (2000-2002). Cox proportional hazards models were used to assess the associations, with adjustment for socioeconomic status, traditional vascular disease risk factors, race/ethnicity, body mass index, diabetes, chronic kidney disease, alcohol intake, and lipid-lowering therapy. Out of 4,395 respondents to a sleep questionnaire administered in MESA, 181 reported PDSA, 1,086 reported HS, and 3,128 reported neither HS nor PDSA (unaffected). Over an average 8.5-year follow-up period, 212 AF events were identified. As compared with unaffected participants, PDSA was associated with incident AF in the multivariable analysis, but HS was not (PDSA: hazard ratio = 1.76, 95% confidence interval: 1.03, 3.02; HS: hazard ratio = 1.02, 95% confidence interval: 0.72, 1.44). PDSA, a marker of more severe sleep apnea, was associated with higher risk of incident AF in this analysis of MESA data.
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Lin et al. (2015) conducted a cohort in Atrial fibrillation (n=4,395). Physician-diagnosed sleep apnea (PDSA) vs. Unaffected participants (neither habitual snoring nor PDSA) was evaluated on Incident atrial fibrillation (HR 1.76, 95% CI 1.03-3.02). Physician-diagnosed sleep apnea was associated with a higher risk of incident atrial fibrillation compared to unaffected participants (HR 1.76; 95% CI 1.03-3.02), whereas habitual snoring was not.
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