Age, BMI, natriuretic peptide levels tied to incident AF risk in CHD
Older age, BMI and higher levels of N-terminal pro-B-type natriuretic peptide were associated with elevated risk for incident atrial fibrillation in patients with CHD, according to findings published in the American Heart Journal.
“In patients with CHD, AF is associated with increased morbidity and mortality,” Maria Tomasdottir, MD, resident in the department of medical sciences, cardiology, at Uppsala University in Sweden, and colleagues wrote. “So far, studies on incidence of AF in patients with CHD are limited and investigations on the factors associated with the predisposition of new AF in patients with CHD are lacking.”
The researchers analyzed 13,153 patients (median age, 64 years; 19% women) with treated CHD previously included in the STABILITY trial for a mean follow-up of 3.5 years. Researchers performed further validation analysis on 1,894 patients (median age, 65 years; 31% women) from the FRISC trial of patients with non-STEMI, with a mean follow-up of 5 years.
During the study period, 4.1% of patients experienced incident AF, with an annual incidence rate of 1.2%. Multivariable models showed older age, increasing BMI, male sex, geographic region, low physical activity and HF were associated with increased risk for AF. Of the biomarkers included in the analysis, only higher levels of NT-proBNP carried an association. HRs for each factor ranged from 1.04 to 1.79 (P .05). The strongest predictors of AF were age (HR per 1-year increase = 1.06; 95% CI, 1.04-1.07; P < .0001), BMI (HR per 1 kg/m2 increase = 1.06; 95% CI, 1.04-1.09; P < .0001) and NT-proBNP (HR per 1-standard deviation increase = 1.14; 95% CI, 1.1-1.19; P < .0001), according to the researchers.
In the validation cohort, 6.8% of patients experienced incident AF, with an annual incidence rate of 1.5%. Similar to the identification cohort, older age, increasing BMI and higher levels of NT-proBNP were associated with increased risk for incident AF.
“Being a high-risk group, patients with known CHD might benefit from screening for AF even more than the general population,” Tomasdottir and colleagues wrote. “The present results suggest that a few selected variables were among the most strongly, and consistently, associated with incident AF; age, NT-proBNP and BMI. Thus, these parameters could be used to improve the risk prediction in these patients.”
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