Key result
Baseline proteinuria (≥2+) was associated with an 83.9% higher risk of incident atrial fibrillation compared to participants without proteinuria (HR 1.839; 95% CI 1.073-3.154; p=0.0267).
Why the study?
Proteinuria is a known cardiovascular risk factor, but whether it independently increases the risk for AF in the Chinese population is unknown.
Does proteinuria increase the risk of incident atrial fibrillation in the general Chinese population?
Cohort (n=60,599)
Does proteinuria increase the risk of incident atrial fibrillation in the general Chinese population?
Proteinuria is an independent risk factor for incident atrial fibrillation, and its resolution mitigates this risk, suggesting it may be a modifiable target for AF prevention.
Answers are grounded in this paper and cite their sources.
Proteinuria may flag higher AF risk warranting monitoring in Chinese adults; extends prior data but leaves causality and prevention open.
BACKGROUND: Proteinuria is a well-known cardiovascular risk factor, but whether it independently increases the risk for atrial fibrillation (AF) in Chinese population is unknown. To address this deficiency, herein, we investigated the association between proteinuria detected using urine dipstick test and the risk of AF. METHODS: This was a prospective cohort study of Kailuan study participants who underwent the 2006-2007 and 2010-2011 health checkups and was free from AF. Participants were classified into four groups based on the level of proteinuria: [-, trace (±), 1+, ≥2+]. The outcome was incident AF as confirmed by 12-lead electrocardiography. RESULTS: During a median of 11.90 years of follow-up, we documented 514 incident AF cases among 60,599 participants. Proteinuria was found in 6302 (10.40%) participants. Relative to participants without proteinuria at the baseline, those with proteinuria (≥2+) had an 83.9% higher risk (95% confidence interval [CI], 1.073-3.154, p = .0267) of developing AF, after adjusted for confounding variables. The result was consistent in the sensitivity analysis. Compared to consistently negative proteinuria, the risk of AF significantly increased in the aggravated proteinuria group (hazard ratio [HR] 1.552, 95% CI 1.140-2.114) and the persistent proteinuria group (HR 2.485, 95% CI 1.414-4.366). Among participants with resolved proteinuria (from positive to negative), the risk of incident AF was not significantly increased compared to those with persistently negative proteinuria (HR 1.300, 95% CI 0.743-2.276). CONCLUSIONS: Proteinuria could be a modifiable risk factor for predicting AF development. Knowing the presence of proteinuria may improve risk stratification for decision-making about AF prevention.
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Li et al. (2023) conducted a cohort in Atrial fibrillation (n=60,599). Proteinuria (≥2+) vs. No proteinuria was evaluated on Incident atrial fibrillation (HR 1.839, 95% CI 1.073-3.154, p=0.0267). Baseline proteinuria (≥2+) was associated with an 83.9% higher risk of incident atrial fibrillation compared to participants without proteinuria (HR 1.839; 95% CI 1.073-3.154; p=0.0267).
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