Abstract 16480: Cardiorespiratory Fitness is Associated With Decreased Risk of Incident Atrial Fibrillation: An Analysis of 66,479 Patients FromThe Henry Ford Hospital Exercise Testing (FIT) Project
Introduction: The prevalence of atrial fibrillation (AF) is increasing in parallel with the aging and increasingly sedentary lifestyle of the population. The relationship of AF with cardiorespiratory fitness (CRF) is poorly understood.
Hypothesis: CRF is inversely associated with risk of incident AF.
Methods: We conducted a retrospective multiethnic cohort (enrolled 1991 - 2009) derived from a multi-hospital metropolitan health system. Patients without known AF and heart failure underwent graded exercise stress test according to Bruce protocol. Primary outcome was new onset AF, which was ascertained by linking with ≥3 encounters with new use of appropriate ICD9 codes. Relationship of CRF measured as peak metabolic equivalents (METs) with incident AF was evaluated in Cox proportional hazard models adjusted for potential confounders.
Results: A total of 66,479 patients (mean age 53±13 y, 54% male, 64% whites) were analyzed. Over a median follow-up duration of 11 y (range 0 - 20 y), there were 4791(7%) incident cases of AF. Patients with incident AF were likely to be older, males, white (60% vs. 53%) and had higher prevalence of hypertension (82% vs. 64%), diabetes (25%vs19%), known cardiovascular disease (33% vs 12%) and less obesity (12 vs 22%). In adjusted Cox proportional hazard model for age, sex, race, resting heart rate, hypertension, hyperlipidemia, diabetes, smoking, known cardiovascular disease and obesity, there was a significant linear relationship between peak METs and incident AF (HR 0.91; 95% CI 0.90 - 0.92, p 12 METS) compared to the lowest quartile of exercise capacity (<6 METS) had a 29% lower risk of developing incident AF (HR 0.71; 95% CI 0.68 - 0.75, p <0.0001) Figure shows time to incident atrial fibrillation by Kaplan-Meier’s method.
Conclusions: This study suggests an independent association of exercise capacity, as measured by peak METs, with incident AF. Further studies will be needed to assess the causality.
Author Disclosures: W. Qureshi: None. M. Blaha: None. C. Brawner: None. S. Keteyian: None. M. Al-Mallah: None.
- © 2014 by American Heart Association, Inc.