High polygenic and clinical risk factor burden was associated with a 48.2% lifetime risk of atrial fibrillation, compared to 22.3% in individuals with low risk.
Cohort (n=4,606)
What is the lifetime risk of atrial fibrillation considering genetic predisposition and clinical risk factor burden in individuals without AF at age 55?
Both polygenic risk and clinical risk factor burden substantially influence the lifetime risk of atrial fibrillation, which is 37.1% overall for individuals free of AF at age 55.
Absolute Event Rate: 48.2% vs 22.3%
p-value: p=<0.001
Background: The long-term probability of developing atrial fibrillation (AF) considering genetic predisposition and clinical risk factor burden is unknown. Methods: We estimated the lifetime risk of AF in individuals from the community-based Framingham Heart Study. Polygenic risk for AF was derived using a score of ≈1000 AF-associated single-nucleotide polymorphisms. Clinical risk factor burden was calculated for each individual using a validated risk score for incident AF comprised of height, weight, systolic and diastolic blood pressure, current smoking status, antihypertensive medication use, diabetes mellitus, history of myocardial infarction, and history of heart failure. We estimated the lifetime risk of AF within tertiles of polygenic and clinical risk. Results: Among 4606 participants without AF at 55 years of age, 580 developed incident AF (median follow-up, 9.4 years; 25th–75th percentile, 4.4–14.3 years). The lifetime risk of AF >55 years of age was 37.1% and was substantially influenced by both polygenic and clinical risk factor burden. Among individuals free of AF at 55 years of age, those in low-polygenic and clinical risk tertiles had a lifetime risk of AF of 22.3% (95% confidence interval, 15.4−9.1), whereas those in high-risk tertiles had a risk of 48.2% (95% confidence interval, 41.3−55.1). A lower clinical risk factor burden was associated with later AF onset after adjusting for genetic predisposition ( P <0.001). Conclusions: In our community-based cohort, the lifetime risk of AF was 37%. Estimation of polygenic AF risk is feasible and together with clinical risk factor burden explains a substantial gradient in long-term AF risk.
Weng et al. (Sun,) conducted a cohort in Atrial fibrillation (n=4,606). High polygenic and clinical risk factor burden vs. Low polygenic and clinical risk factor burden was evaluated on Lifetime risk of atrial fibrillation >55 years of age (p=<0.001). High polygenic and clinical risk factor burden was associated with a 48.2% lifetime risk of atrial fibrillation, compared to 22.3% in individuals with low risk.