Zakaria Almuwaqqat1,2, J 'Neka S Claxton3, Faye L Norby4, Pamela L Lutsey4, Jingkai Wei5, Elsayed Z Soliman6, Lin Y Chen4,7, Kunihiro Matsushita8, Gerardo Heiss9, Alvaro Alonso3. 1. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA. zalmuwa@emory.edu. 2. Department of Medicine, Division of Cardiology, Emory School of Medicine, 1364 Clifton Rd NE, Atlanta, GA, 30322, USA. zalmuwa@emory.edu. 3. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA. 4. Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA. 5. Department of Epidemiology and Biostatistics, George Washington University, Washington, D.C, USA. 6. Epidemiological Cardiology Research Center, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA. 7. Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA. 8. Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health and the Division of General Internal Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA. 9. Department of Epidemiology, Gilling's School Public Health, University of North Carolina, Chapel Hill, NC, USA.
Abstract
BACKGROUND: Stiff arteries increase left ventricular (LV) end-systolic workload, leading over time to left atrial and ventricular remodeling, and providing the substrate for atrial fibrillation (AF) development. We investigated if carotid femoral pulse wave velocity (cfPWV), a measure of central arterial stiffness, is associated with incident AF. METHODS: In 2011-2013, cfPWV was measured in 3882 participants of the Atherosclerosis Risk in Communities Cohort Study (ARIC) without prevalent AF. Participants were followed through 2017 for the incidence of AF. Individuals were categorized in cfPWV quartiles based on visit measurements. Multivariable Cox regression models were used to evaluate the association of cfPWV with incident AF. RESULTS: Mean age was 75 years (SD 5), 60% were female and 20% were African American. Over a median follow-up of 5.5 years we identified 331 incident cases of AF. cfPWV demonstrated U-shaped associations with AF risk. In models adjusted for age, race, center, sex, education levels, and hemodynamic and clinical factors, hazard ratios (HR) of AF for participants in the first, third and fourth quartiles were 1.49 (95% CI 1.06, 2.10), 1.59 (1.14, 2.10), and 1.56(1.10, 2.19), respectively, compared to those in the second quartile. CONCLUSION: Among community-dwelling older adults, low and high central arterial stiffness is associated with AF risk.
BACKGROUND: Stiff arteries increase left ventricular (LV) end-systolic workload, leading over time to left atrial and ventricular remodeling, and providing the substrate for atrial fibrillation (AF) development. We investigated if carotid femoral pulse wave velocity (cfPWV), a measure of central arterial stiffness, is associated with incident AF. METHODS: In 2011-2013, cfPWV was measured in 3882 participants of the Atherosclerosis Risk in Communities Cohort Study (ARIC) without prevalent AF. Participants were followed through 2017 for the incidence of AF. Individuals were categorized in cfPWV quartiles based on visit measurements. Multivariable Cox regression models were used to evaluate the association of cfPWV with incident AF. RESULTS: Mean age was 75 years (SD 5), 60% were female and 20% were African American. Over a median follow-up of 5.5 years we identified 331 incident cases of AF. cfPWV demonstrated U-shaped associations with AF risk. In models adjusted for age, race, center, sex, education levels, and hemodynamic and clinical factors, hazard ratios (HR) of AF for participants in the first, third and fourth quartiles were 1.49 (95% CI 1.06, 2.10), 1.59 (1.14, 2.10), and 1.56(1.10, 2.19), respectively, compared to those in the second quartile. CONCLUSION: Among community-dwelling older adults, low and high central arterial stiffness is associated with AF risk.
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