Abstract 13118: Predictive Impact of Plasma Aldosterone Levels on the Future Risk of New-Onset Atrial Fibrillation
Background : Upstream therapy may have the potential to decrease the incidence of atrial fibrillation (Af). Renin-angiotensin-aldosterone system has been reported as one of the risk factors of Af. However, roles of aldosterone (ALD) and predictor of new-onset Af are still unclear. We therefore evaluated predictive value of plasma ALD levels on the incidence of Af.
Methods : The levels of plasma ALD were quantified in a prospective cohort study of 796 consecutive outpatient clinic patients initially free from Af (477 men, 319 women, age 68.5±12.6). The subjects were divided into two groups of elevated ALD group (group H) and non-elevated ALD group (group L) according to the median value of baseline plasma ALD for data analysis. The primary end point of the study was new-onset Af. The secondary end point was cardiac death and all cause death.
Results : The median value of baseline ALD was 89.0 pg/mL in all patients. During a median follow-up of 941 days, incidence of new-onset Af was 7.5%. Patients of group H had a significantly higher Af incidence rates, as compared to those of group L (12.5% vs.2.5%, p<0.0001). Both cardiac mortality and all cause mortality rates were higher in group H than in group L (7.8% vs. 1.0%, 11.0% vs. 5.3%, respectively). Elevated ALD were independent predictor of increased future incident Af risk in Cox regression analyses adjusted for age, sex, body mass index, C-reactive protein and brain natriuretic peptide. The adjusted hazard ratio of higher ALD was 3.691 (95% CI, 1.962-6.942; P<0.0001).
Conclusions : In Japanese outpatient clinic patients without Af, higher plasma levels of ALD was independent predictor of developing Af. Although the cause of ALD level elevation remains unclear, raised ALD may be one of the risk factors of incident Af.
- © 2011 by American Heart Association, Inc.