Selenium intake deficiency was independently associated with an increased risk of new-onset atrial fibrillation in high-risk cardiovascular patients (HR 10.5; 95% CI 1.1-99.0; P=0.041).
Cohort (n=558)
Does selenium intake deficiency increase the risk of incident atrial fibrillation in high-risk cardiovascular patients?
Very low selenium intake is independently associated with increased incident atrial fibrillation and altered expressions of circulating early and late endothelial progenitor cells in cardiovascular patients.
Effect estimate: HR 10.5 (95% CI 1.1-99.0)
p-value: p=0.041
Abstract Background Selenium deficiency was associated with heart failure and adverse arterial function. However, how this affects circulating expressions of endothelial progenitor cells (EPCs) and clinical risk of atrial fibrillation (AF), a condition linked to endothelial dysfunction, was unclear. Objective To investigate the relations between selenium intake deficiency and circulating expressions of EPCs and clinical event risk of AF. Methods We prospectively investigated 558 high-risk patients with prior coronary disease, ischemic stroke and/ or type 2 diabetes in a clinical cohort. CD34+/KDR+ and CD133+/KDR+ circulating EPCs were determined by flow cytometry. New-onset AF was ascertained over a 5-year follow-up period. Selenium intake deficiency was defined as 22microgram/day based on prior pilot data as determined from a validated food frequency questionnaire. Results Over 63±11 months, 2% patients (9/558) developed new-onset AF. Selenium intake deficiency (prevalence 16%) was associated with increased risk of new-onset AF (chi-square P=0.001). C-statistic for prediction of AF by selenium intake deficiency was 0.70 (P=0.040). Kaplan-Meier analysis showed that selenium intake deficiency was associated with reduced AF event-free survival (log-rank 17.7, P0.001, Figure). Adjusted for potential confounders (age, gender, smoking, history of coronary disease/ stroke, body-mass index, systolic/ diastolic blood pressure, pulse rate, serum LDL, HDL and triglycerides, HbA1c, statin/ aspirin use), selenium intake deficiency remained independently associated with increased risk of AF (HR 10.5 95%CI 1.1-99.0, P=0.041). Mechanistically, selenium intake deficiency was associated with reduced CD34+/KDR+ EPC and raised CD133+/KDR+ EPC. Conclusions Very low selenium intake is independently associated with increased incident AF in cardiovascular patients. Furthermore, it is linked to altered expressions of circulating early and late EPCs. These may provide a mechanistic basis for the observed adverse cardiovascular risk. Confirmation with randomised controlled trials is required.For image description, please refer to the figure legend and surrounding text.
Chan et al. (Fri,) conducted a cohort in Cardiovascular disease (prior coronary disease, ischemic stroke and/or type 2 diabetes) (n=558). Selenium intake deficiency vs. Adequate selenium intake was evaluated on New-onset atrial fibrillation (HR 10.5, 95% CI 1.1-99.0, p=0.041). Selenium intake deficiency was independently associated with an increased risk of new-onset atrial fibrillation in high-risk cardiovascular patients (HR 10.5; 95% CI 1.1-99.0; P=0.041).
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