Airflow Obstruction, Lung Function, and Incidence of Atrial Fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study
Background—Reduced low forced expiratory volume in 1 second (FEV1) is reportedly associated with an increased risk of atrial fibrillation (AF). Extant reports do not provide separate estimates for never smokers, and for African Americans, who incongruously have lower AF incidence than Caucasians.
Methods and Results—We examined 15,004 middle-aged African Americans and Caucasians enrolled in ARIC cohort study. Standardized spirometry were collected at the baseline examination. Incident AF was identified from the first among the following: ICD codes for AF on hospital discharge records or death certificates or 12-lead ECGs performed during three triennial follow-up visits. Over an average follow-up of 17.5 years, a total of 1,691 (11%) participants developed new onset AF. The rate of incident AF was inversely associated with FEV1 in each of the four race and gender- groups. After multivariable adjustment for traditional cardiovascular disease risk factors and height, hazard ratios (95% confidence intervals) of AF comparing the lowest with the highest quartile of FEV1 were 1.37(1.02,1.83) for white women, 1.49(1.16,1.91) for white men, 1.63(1.00,2.66) for black women, and 2.36(1.30,4.29) for black men. The above associations were observed across all smoking status categories. Moderate/severe airflow obstruction (FEV1/FVC<0.70 and FEV1< 80% of predicted value) was also associated with higher AF incidence.
Conclusions—In this large population-based study with a long term follow-up, reduced FEV1 and obstructive respiratory disease were inversely - associated with a higher AF incidence after adjusting for measured confounders.
- Received May 23, 2013.
- Revision received November 11, 2013.
- Accepted November 20, 2013.