Abstract 3160: Inflammation and Risk of Incident Atrial Fibrillation in Women
Background One study among elderly individuals showed an association between levels of high sensitivity C-reactive protein (hsCRP) and the development of new onset atrial fibrillation (AF). However, prospective information in other individuals is scarce, and given the multifactorial pathogenesis of inflammation, evaluation of multiple biomarkers may provide additional information.
Methods We prospectively followed 24705 healthy, middle-aged women (median age 53 years) from the Women’s Health Study, who were free of AF at baseline and who provided a baseline blood sample assayed for hsCRP, soluble intercellular adhesion molecule-1 (sICAM-1) and fibrinogen. Using these biomarkers, we created an inflammation score that reflected the number of biomarkers in the highest tertile per individual. Time to incident AF, confirmed by medical record review, was assessed using Cox proportional-hazards models.
Results During 12.4 years of follow-up, 512 incident AF events occurred. Median (interquartile range) levels of hsCRP, sICAM-1 and fibrinogen were 2.0 (0.8 – 4.3) mg/L, 342 (300 –393) ng/mL and 350 (307– 402) mg/dL, respectively. Spearman correlation coefficients were 0.29 for hsCRP-sICAM-1, 0.41 for hsCRP-fibrinogen and 0.27 for sICAM-1-fibrinogen, suggesting only moderate correlations. Risk estimates for the inflammation score are shown in the Table⇓. In models adjusted for traditional cardiovascular risk factors, the risk of incident AF significantly increased across inflammation score categories (p=0.0008). This significant trend persisted after additional adjustment for body mass index (p=0.04). In the fully adjusted model, those with all three biomarkers in the highest tertile had a significant 44% increase in risk of incident AF (Table⇓).
Conclusion Inflammation is an important predictor of incident AF. While a substantial part of this risk is mediated by body mass index, multimarker evaluation revealed an independent inflammatory component.