Abstract 10050: Peripheral Blood Metabolic Profiles Predict the Future Occurrence of New Onset Atrial Fibrillation
Background: Atrial fibrillation (AF) is common and leads to significant morbidity and mortality. Metabolic profiling of atrial tissue has yielded mechanistic insights into post-operative AF. We hypothesized that peripheral blood metabolic profiles are associated with new onset non-operative AF.
Methods: We performed targeted mass spectrometry-based quantification of 69 metabolites and routine lipid assessment in frozen, fasting plasma from 2023 consecutive patients undergoing coronary angiography and included in the MURDOCK CV molecular profiling cohort. We created 13 uncorrelated factors from the data using principal components analysis (PCA). Cox proportional hazards modeling assessed the associations of these PCA-derived factors with new onset AF in patients without baseline AF. Adjusted associations considered clinical factors previously associated with new onset AF: age, sex, race, hypertension, ejection fraction (EF) and chronic obstructive pulmonary disease (COPD). We also adjusted for index clinical presentation (acute MI vs. other).
Results: Of 1938 patients without baseline AF, 1856 had complete metabolite and clinical data. Over a median 3.5 years, there were 245 new AF cases (13.2%). They were older (median 67 vs. 61 years); more often white (83 vs. 71%) and male (68 vs. 60%) and had more COPD (8 vs. 5%). Hypertension was common in both groups (69 vs. 67%). EF (%) was slightly lower in AF cases (median 56 vs. 58). Of 13 PCA-derived factors, 3 were significantly (p<0.05) associated with new onset AF after adjustment (Table). Factors 2 and 5 remained significant after Bonferroni correction.
Conclusion: Metabolic profiles independently predict new onset AF among patients referred for coronary angiography. If validated, these observations could lead to novel mechanistic understanding of AF risk and opportunities for new prevention and treatment strategies. Table: Association of PCA-derived Metabolic Factors with New Onset Atrial Fibrillation
- © 2011 by American Heart Association, Inc.