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A cohort study examination of established and emerging risk factors for atrial fibrillation: the Busselton Health Study

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Abstract

Atrial fibrillation (AF) is the most common chronic arrhythmia in adults and its prevalence is increasing. Due to its serious cardiovascular complications there is a strong need to understand predisposing risk factors to develop effective prevention strategies. There are a few established risk factors but a number of further risk factors have been suggested including obesity, metabolic syndrome, sleep-disordered breathing, and inflammation. The aim of this study was to investigate established and emerging risk factors for AF in a cohort study of 4,267 adults in Busselton, Western Australia, without a history of AF at baseline in 1994/95 who were followed for 15 years for incident AF events. Baseline measurement included questionnaire, clinical assessment and blood sample. A total of 343 (8 %) experienced AF during follow-up. Cox regression analysis confirmed advancing age, male sex, taller height, being on hypertension treatment and higher body mass index (BMI) as the major common risk factors (all p < 0.001). However, further modelling showed the effect of being on hypertension treatment may be stronger in women (p = 0.001) and the effect of BMI stronger in men (p = 0.004). After adjustment for these factors, no other factors were strongly related (p < 0.001) although short PR interval, history of valvular heart disease, stroke, chronic obstructive pulmonary disease, lung function and adiponectin level were marginally related (p < 0.05). This cohort study of predictors for incident AF has confirmed the major established risk factors. However, recently suggested potential novel risk factors for AF (inflammation, sleep-disordered breathing, glucose/metabolic disorders) were not confirmed in this study.

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Acknowledgments

The 1994/95 Busselton health survey was supported by a grant from the Health Promotion Foundation of Western Australia. This analysis was supported by a grant from the National Health and Medical Research Council of Australia (Project number 1020373). We would like to acknowledge the Data Linkage Branch (Department of Health WA) for extraction and provision of the linked hospital admission and death data, the Busselton Population Medical Research Institute for permission to access the survey data, and the residents of Busselton for their long-standing support of the Busselton health surveys.

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Knuiman, M., Briffa, T., Divitini, M. et al. A cohort study examination of established and emerging risk factors for atrial fibrillation: the Busselton Health Study. Eur J Epidemiol 29, 181–190 (2014). https://doi.org/10.1007/s10654-013-9875-y

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