September 10, 2026Circulation Heart Failure0 citations
Atrial Fibrillation Epidemiology, Risk Factors, and Outcomes in Genotyped Dilated Cardiomyopathy
Atrial Fibrillation in Genotyped Dilated Cardiomyopathy: Epidemiology, Risk Factors, and Outcomes: Insights From the SHaRe Registry
Why the study?
The genetic determinants of atrial fibrillation risk and its prognostic significance across genotyped dilated cardiomyopathy subtypes remained unknown.
Does genotype status affect the risk of incident atrial fibrillation and subsequent adverse clinical outcomes in patients with dilated cardiomyopathy?
Population
3117 genotyped patients with DCM from the SHaRe registry
Comparison
Genotype-positive vs genotype-negative status across DCM subtypes
Design
Observational cohort study
Follow-up
Median 4.5 years
Key result
In dilated cardiomyopathy, the LMNA genotype was associated with an increased risk of incident atrial fibrillation compared to genotype-negative patients (HR 5.52; 95% CI 3.84-7.95; P<0.001).
Authors
Discussion
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Overview
LMNA carriers with dilated cardiomyopathy may warrant closer AF monitoring; extends genotype-specific risk data but leaves practice change open pending trials.
Key Points
- To determine the incidence, genetic predictors, and prognostic significance of atrial fibrillation across genotypes in patients with dilated cardiomyopathy.
- Analyzed an observational cohort of 3,117 genotyped patients with dilated cardiomyopathy from the SHaRe registry (mean age 48±15 years; 39% female; 35% genotype-positive).
- Followed patients over a median of 4.5 years (interquartile range, 1.6–9.0) using multivariable Cox regression and time-dependent modeling to evaluate incident atrial fibrillation and composite clinical outcomes.
- LMNA variants carried the highest atrial fibrillation incidence (7.6 per 100 patient-years; 56.7% cumulative prevalence) and was the only genotype independently associated with incident atrial fibrillation compared with genotype-negative status (hazard ratio, 5.52 [95% CI, 3.84–7.95]; P <0.001).
- TTN variants had an atrial fibrillation incidence of 2.1 per 100 patient-years and cumulative prevalence of 24.4%, which was comparable to genotype-negative patients.
- Development of atrial fibrillation independently increased the risk of the composite clinical outcome of heart failure, ventricular arrhythmias, and all-cause mortality (hazard ratio, 1.58 [95% CI, 1.29–1.94]; P <0.001).
Study Design
Type
Cohort (n=3,117)
Structured PICO
Does genotype status affect the risk of incident atrial fibrillation and subsequent adverse clinical outcomes in patients with dilated cardiomyopathy?
P
Population
3117 genotyped patients with dilated cardiomyopathy (mean age 48 years, 39% female) followed for a median of 4.5 years.
E
Exposure
Genotype-positive status (specifically LMNA, TTN, and other DCM-associated genes)
C
Comparator
Genotype-negative [G(-)] status (negative genetic testing)
O
Outcome
Incident atrial fibrillation and a composite clinical outcome including heart failure, ventricular arrhythmias, and all-cause mortalitycomposite
In patients with dilated cardiomyopathy, the LMNA genotype is strongly associated with incident atrial fibrillation, which in turn increases the risk of heart failure, ventricular arrhythmias, and mortality.
Main Result
Hazard Ratio: 5.52 (95% CI 3.84–7.95)
p-value: p=<0.001
Cite This Study
Balakrishnan et al. (2026) conducted a cohort in Dilated Cardiomyopathy (n=3,117). LMNA genotype vs. Genotype-negative patients was evaluated on Incident atrial fibrillation (HR 5.52, 95% CI 3.84-7.95, p=<0.001). In dilated cardiomyopathy, the LMNA genotype was associated with an increased risk of incident atrial fibrillation compared to genotype-negative patients (HR 5.52; 95% CI 3.84-7.95; P<0.001).