Key result
Markers of immunothrombosis, including fibrinogen (HR 1.00), von Willebrand factor, ADAMTS13, and NETs, were not significantly associated with the risk of new-onset atrial fibrillation.
Why the study?
The etiology underlying atrial fibrillation remains largely unknown, and immunothrombosis may cause atrial remodeling and serve as an underlying cause of the arrhythmia.
Do baseline markers of immunothrombosis predict new-onset atrial fibrillation in the general population?
Cohort (n=6,174)
No
Do baseline markers of immunothrombosis predict new-onset atrial fibrillation in the general population?
Answers are grounded in this paper and cite their sources.
Baseline markers of immunothrombosis (fibrinogen, vWF, ADAMTS13, NETs) do not independently predict new-onset atrial fibrillation in the general population, challenging their added value in AF risk prediction.
BACKGROUND: Atrial fibrillation (AF) is the most common age-related cardiac arrhythmia. The etiology underlying AF is still largely unknown. At the intersection of the innate immune system and hemostasis, immunothrombosis may be a possible cause of atrial remodeling, and therefore be an underlying cause of AF. METHODS: From 1990 to 2014, we followed participants aged 55 and over, free from AF at inclusion. Immunothrombosis factors fibrinogen, von Willebrand factor, ADAMTS13, and neutrophil extracellular traps (NETs) levels were measured at baseline. Participants were followed until either onset of AF, loss-to-follow-up, or reaching the end-date of 01-01-2014. Cox proportional hazard modelling was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for cardiovascular risk factors. RESULTS: We followed 6174 participants (mean age 69.1 years, 57% women) for a median follow-up time of 12.8 years. 364 men (13.7%, incidence rate 13.0/1000 person-years) and 365 women (10.4%, incidence rate 8.9/1000 person-years) developed AF. We found no significant association between markers of immunothrombosis and new-onset AF after adjusting for cardiovascular risk factors [HR 1.00 (95% CI 0.93-1.08) for fibrinogen, 1.04 (0.97-1.12) for von Willebrand factor, 1.00 (1.00-1.01) for ADAMTS13, and 1.01 (0.94-1.09) for NETs]. In addition, we found no differences in associations between men and women. CONCLUSION: We found no associations between markers of immunothrombosis and new-onset AF in the general population. Inflammation and immunothrombosis may be associated with AF through other cardiovascular risk factors or predisposing conditions of AF. Our findings challenge the added value of biomarkers in AF risk prediction.
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Tilly et al. (2021) conducted a cohort in New-onset atrial fibrillation (n=6,174). Immunothrombosis markers (fibrinogen, vWF, ADAMTS13, NETs) vs. Per 1-SD increment was evaluated on New-onset atrial fibrillation (HR 1.00, 95% CI 0.93-1.08). Markers of immunothrombosis, including fibrinogen (HR 1.00), von Willebrand factor, ADAMTS13, and NETs, were not significantly associated with the risk of new-onset atrial fibrillation.
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