Plasminogen activator inhibitor-1 and tissue plasminogen activator and incident AF: Data from the PREVEND study

Background Tissue-type plasminogen activator (TPA) and plasminogen activator inhibitor-1 (PAI-1) have been shown to be associated with increased risk for stroke, however, the association with incident atrial fibrillation (AF) is unknown. Methods We examined 8265 individuals included in the PREVEND study. In all subjects, PAI-1 and TPA plasma/serum levels were measured using an ELISA kit. By means of univariate and multivariate analyses the association with incident AF was assessed. Results Mean age was age 49 ± 13 years, and 50% were women. Of the 8265 patients free of AF at baseline, 267 (3.2%) patients developed incident AF during a mean follow-up of 9.7 ± 2.4 years. Baseline median levels of PAI-1 and TPA were 72.4 ng/ml and 3.1 ng/ml, respectively. In univariate analyses PAI-1 (Hazard ratio [HR] 1.10 95% Confidence interval [CI] 1.04–1.16, p < 0.001) and TPA (HR 1.05, 95% CI 1.01–1.08, p = 0.014) were associated with incident AF. However, after multivariate adjustment for age, sex, antihypertensive drugs, stroke, heart failure, myocardial infarction, diabetes mellitus, peripheral arterial disease, smoking, NT-proBNP, alcohol consumption, body mass index no significant association was found. Conclusion In this community-based cohort, PAI-1 and TPA levels were not associated with incident AF.