Abstract 16240: Genetic Risk Factors Associated With Development of Paroxysmal versus Non-Paroxysmal Atrial Fibrillation
Introduction: Several genetic polymorphisms have been associated with incident atrial fibrillation (AF).Whether these genetic risk factors differ with regard to development of non-paroxysmal rather than paroxysmal AF remains unknown.
Methods: A total of 20,802 women of European ancestry from the Women’s Genome Health Study (WGHS) without known cardiovascular disease, heart failure, or AF at baseline were followed for incident AF. Genome wide genotyping was performed with Infinium II technology. AF was classified as: paroxysmal (self-terminating <7 days), persistent (requiring cardioversion or lasting ≥ 7 days), and permanent (≥ 1 year and/or attempts to convert rhythm abandoned) within 2 years of initial AF diagnosis. Persistent and permanent AF were categorized together for this analysis. All AF events were confirmed by medical record review. A competing risk analysis using Cox proportional hazard models were performed and likelihood ratio tests were utilized to test the equality of genetic risk factor associations with AF types
Results: During a median follow-up of 16.4years (IQR 15.7:16.8),695 women developed incident AF. Of these, 241 (35%) developed non-paroxysmal AF whereas 454 (65%) remained paroxysmal. Ten different SNPs exhibited significant adjusted hazard ratios with one or both AF types (Table 1). SNP rs1152591 in SYNE2 had a stronger association with development of non-paroxysmal AF compared to non-paroxysmal AF (p for non-equality =0.03) and there was a trend toward a stronger positive association with non-paroxysmal AF for rs7164883 in HCN4 (p for non-equal association=0.08). Several SNPs exhibited quite similar effects on paroxysmal and non-paroxysmal AF.
Conclusions: In this large prospective cohort of apparently healthy women,we observed a significant differential association with rs1152591 (SYNE2) and non-paroxysmal AF compared with paroxysmal AF. These intriguing findings require independent confirmation.
- © 2013 by American Heart Association, Inc.