Researchers find link between familial and new-onset AF

**Lubitz S. JAMA. 2010;doi:10.1001/jama.2010.1690.**

New-onset atrial fibrillation was found to be most common among those with familial atrial fibrillation when compared with those without familial atrial fibrillation, an association not attenuated by adjustment for atrial fibrillation risk factors, according to study data.

“We report an association between the occurrence of AF in a first-degree relative and risk of new-onset AF in 4,421 individuals of European descent,” the researchers commented in their study, adding that the findings support and extend previous reports of AF heritability.

The study included participants from the Framingham Heart Study who were at least 30 years of age, free of AF at baseline examination and had at least one parent or sibling enrolled in the study. Researchers followed up with the final study group (n=4,421; mean age, 54 years; 54% women) through 2007.

After 11,971 examinations, researchers reported familial AF in 1,185 participants (26.8%), with premature familial AF occurring in 351 cases (7.9%). Those with familial AF had a more common occurrence of AF than those without (5.8% vs. 3.1%), which was not attenuated, even after adjustment for AF risk factors (multivariable-adjusted HR=1.40; 95% CI, 1.13-1.74) or reported AF-related genetic variants.

Further data indicated that among the different features of familial AF examined, premature familial AF was associated with the greatest improved discrimination beyond traditional risk factors (P=.004).

As recommendations for additional research, the study investigators wrote, “Future efforts should attempt to discern the factors that mediate the association between familial AF and AF risk, further explore the relationships between premature familial AF and risk prediction, and determine whether incorporating genetic variants into an AF prediction model enhances its performance.”

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