Abstract 18065: Prospective Evaluation of a Genetic Risk Score for Atrial Fibrillation in Patients Undergoing Extended Cardiac Rhythm Monitoring
Introduction: Atrial fibrillation (AF) is the most commonly encountered arrhythmia. AF is associated with elevated risk of stroke. Thus, it is critical to accurately identify patients at the highest risk for developing AF to initiate appropriate surveillance and/or treatment to reduce the risk of stroke. In addition to clinical risk factors for AF, several genome-wide association studies have identified and replicated a panel of single nucleotide polymorphisms (SNPs) that are associated with incidence of AF.
Hypothesis: Our primary hypothesis is that an AF genetic risk score (AF-GRS) comprising SNPs that are associated with AF is associated with the AF among previously undiagnosed patients at high risk for AF.
Methods: Patients presenting to their outpatient doctor with symptoms leading to high clinical suspicion for AF and at least one clinical risk factor for AF were recruited to have genetic testing and to wear an ambulatory cardiac rhythm monitor (ZIO Patch, iRhythm San Francisco). Additionally, patients presenting to a clinic or acute care settings with a first ever diagnosis of AF by electrocardiogram (ECG) were enrolled for genetic testing. An AF-GRS was calculated using 12 SNPs for all patients as previously determined in prior studies.
Results: A total of 904 participants completed the study. The mean age was 66.2 (SD 11.8) years and 38% of participants were males. In this group, 85 patients had AF events (44 by ZIO Patch, 41 by ECG). Participants in the top quintile of AF-GRS were more likely (OR 2.87, 95%CI 1.24 - 6.67, p = 0.006) to present with AF or to have paroxysmal AF identified by ZIO Patch during the study period compared with participants in the bottom quintile after adjusting for age, sex, BMI, diabetes, heart failure and myocardial infarction.
Conclusions: In the first prospective study of its kind we demonstrate the ability of a 12-SNP GRS to identify participants with greater likelihood of AF diagnosis at presentation (by ECG) or periods of AF on extended cardiac rhythm monitoring. Combined with clinical risk factors for AF, an AF-GRS may be useful for identifying patients at the highest risk for developing atrial fibrillation.
Author Disclosures: E.D. Muse: None. E.G. Spencer: None. N.E. Wineinger: None. M. Peters: None. P. Barrett: None. S.P. Rivera: Employment; Significant; Quest Diagnostics. J.G. Wohlgemuth: Employment; Significant; Quest Diagnostics. J.J. Devlin: Employment; Significant; Quest Diagnostics. D.X. Shiffman: Employment; Significant; Quest Diagnostics. E.J. Topol: Research Grant; Significant; Quest Diagnostics. Other Research Support; Modest; iRhythm. Consultant/Advisory Board; Modest; Quest Diagnostics.
- © 2016 by American Heart Association, Inc.