Daniel R Douce1, Elsayed Z Soliman2, Rakhi Naik3, Hyacinth I Hyacinth4, Mary Cushman1, Cheryl A Winkler5, George Howard6, Ethan M Lange7, Leslie A Lange7, Marguerite R Irvin8, Neil A Zakai9. 1. University of Vermont College of Medicine, Department of Hematology & Oncology, United States of America. 2. Wake Forest University, Department of Epidemiology & Prevention, United States of America. 3. Johns Hopkins University School of Medicine, Department of Hematology & Oncology, United States of America. 4. Aflac Cancer and Blood Disorder Center of Emory University, Department of Pediatrics and Children's Healthcare of Atlanta, United States of America. 5. National Cancer Institute, Basic Research Laboratory, United States of America. 6. University of Alabama at Birmingham School of Public Health, Department of Biostatistics, United States of America. 7. Department of Medicine, University of Colorado Anschutz Medical Campus, United States of America. 8. University of Alabama at Birmingham School of Public Health, Department of Epidemiology, United States of America. 9. University of Vermont College of Medicine, Department of Hematology & Oncology, United States of America. Electronic address: neil.zakai@med.uvm.edu.
Abstract
BACKGROUND: Sickle cell trait (SCT), sickle cell disease's (SCD) carrier status, has been recently associated with worse cardiovascular and renal outcomes. An increased prevalence of atrial fibrillation (AF) is documented in SCD patients; however, studies in individuals with SCT are lacking. OBJECTIVES: To determine the association of SCT with AF. METHODS: Among African-American participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study we assessed the association of SCT (by ECG or medical history) with prevalent AF using logistic regression adjusting for age, sex, income, education, history of stroke, myocardial infarction, diabetes, hypertension, and chronic kidney disease. A second evaluation was performed a mean of 9.2 years later among available participants, and the same model was used to test the association of SCT with incident AF. RESULTS: In 10,409 participants with baseline ECG data and genotyping, 778 (7.5%) had SCT and 811 (7.8%) had prevalent AF. After adjusting for age, sex, education and income, SCT was associated with AF, OR 1.32 (95% CI 1.03-1.70). The association with incident AF assessed at the second in-home visit with the same adjustments was similar; OR 1.25 (95% CI 0.77-2.03). CONCLUSIONS: SCT was associated with a higher prevalence of AF and a non-significantly higher incident AF over a 9.2 year period independent of AF risk factors. SCT remained associated with prevalent AF after adjusting for potential factors on the causal pathway such as hypertension and chronic kidney disease suggesting alternate mechanisms for the increased risk.
BACKGROUND: Sickle cell trait (SCT), sickle cell disease's (SCD) carrier status, has been recently associated with worse cardiovascular and renal outcomes. An increased prevalence of atrial fibrillation (AF) is documented in SCDpatients; however, studies in individuals with SCT are lacking. OBJECTIVES: To determine the association of SCT with AF. METHODS: Among African-American participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study we assessed the association of SCT (by ECG or medical history) with prevalent AF using logistic regression adjusting for age, sex, income, education, history of stroke, myocardial infarction, diabetes, hypertension, and chronic kidney disease. A second evaluation was performed a mean of 9.2 years later among available participants, and the same model was used to test the association of SCT with incident AF. RESULTS: In 10,409 participants with baseline ECG data and genotyping, 778 (7.5%) had SCT and 811 (7.8%) had prevalent AF. After adjusting for age, sex, education and income, SCT was associated with AF, OR 1.32 (95% CI 1.03-1.70). The association with incident AF assessed at the second in-home visit with the same adjustments was similar; OR 1.25 (95% CI 0.77-2.03). CONCLUSIONS: SCT was associated with a higher prevalence of AF and a non-significantly higher incident AF over a 9.2 year period independent of AF risk factors. SCT remained associated with prevalent AF after adjusting for potential factors on the causal pathway such as hypertension and chronic kidney disease suggesting alternate mechanisms for the increased risk.
Authors: Elsayed Z Soliman; George Howard; James F Meschia; Mary Cushman; Paul Muntner; Patrick M Pullicino; Leslie A McClure; Suzanne Judd; Virginia J Howard Journal: Stroke Date: 2011-08-04 Impact factor: 7.914
Authors: Virginia J Howard; Mary Cushman; Leavonne Pulley; Camilo R Gomez; Rodney C Go; Ronald J Prineas; Andra Graham; Claudia S Moy; George Howard Journal: Neuroepidemiology Date: 2005-06-29 Impact factor: 3.282
Authors: Jonathan P Piccini; Bradley G Hammill; Moritz F Sinner; Paul N Jensen; Adrian F Hernandez; Susan R Heckbert; Emelia J Benjamin; Lesley H Curtis Journal: Circ Cardiovasc Qual Outcomes Date: 2012-01-10
Authors: Andrew S Levey; Paul E de Jong; Josef Coresh; Meguid El Nahas; Brad C Astor; Kunihiro Matsushita; Ron T Gansevoort; Bertram L Kasiske; Kai-Uwe Eckardt Journal: Kidney Int Date: 2010-12-08 Impact factor: 10.612