TY - JOUR
T1 - Comparison of Cardiovascular Risk Factors in European Population Cohorts for Predicting Atrial Fibrillation and Heart Failure, Their Subsequent Onset, and Death
AU - Schrage, Benedikt
AU - Geelhoed, Bastiaan
AU - Niiranen, Teemu J
AU - Gianfagna, Francesco
AU - Vishram-Nielsen, Julie K K
AU - Costanzo, Simona
AU - Söderberg, Stefan
AU - Ojeda, Francisco M
AU - Vartiainen, Erkki
AU - Donati, Maria Benedetta
AU - Magnussen, Christina
AU - Di Castelnuovo, Augusto
AU - Camen, Stephan
AU - Kontto, Jukka
AU - Koenig, Wolfgang
AU - Blankenberg, Stefan
AU - de Gaetano, Giovanni
AU - Linneberg, Allan
AU - Jørgensen, Torben
AU - Zeller, Tanja
AU - Kuulasmaa, Kari
AU - Tunstall-Pedoe, Hugh
AU - Hughes, Maria
AU - Iacoviello, Licia
AU - Salomaa, Veikko
AU - Schnabel, Renate B
PY - 2020/5/5
Y1 - 2020/5/5
N2 - Background Differences in risk factors for atrial fibrillation (AF) and heart failure (HF) are incompletely understood. Aim of this study was to understand whether risk factors and biomarkers show different associations with incident AF and HF and to investigate predictors of subsequent onset and mortality. Methods and Results In N=58 693 individuals free of AF/HF from 5 population-based European cohorts, Cox regressions were used to find predictors for AF, HF, subsequent onset, and mortality. Differences between associations were estimated using bootstrapping. Median follow-up time was 13.8 years, with a mortality of 15.7%. AF and HF occurred in 5.0% and 5.4% of the participants, respectively, with 1.8% showing subsequent onset. Age, male sex, myocardial infarction, body mass index, and NT-proBNP (N-terminal pro-B-type natriuretic peptide) showed similar associations with both diseases. Antihypertensive medication and smoking were stronger predictors of HF than AF. Cholesterol, diabetes mellitus, and hsCRP (high-sensitivity C-reactive protein) were associated with HF, but not with AF. No variable was exclusively associated with AF. Population-attributable risks were higher for HF (75.6%) than for AF (30.9%). Age, male sex, body mass index, diabetes mellitus, and NT-proBNP were associated with subsequent onset, which was associated with the highest all-cause mortality risk. Conclusions Common risk factors and biomarkers showed different associations with AF and HF, and explained a higher proportion of HF than AF risk. As the subsequent onset of both diseases was strongly associated with mortality, prevention needs to be rigorously addressed and remains challenging, as conventional risk factors explained only 31% of AF risk.
AB - Background Differences in risk factors for atrial fibrillation (AF) and heart failure (HF) are incompletely understood. Aim of this study was to understand whether risk factors and biomarkers show different associations with incident AF and HF and to investigate predictors of subsequent onset and mortality. Methods and Results In N=58 693 individuals free of AF/HF from 5 population-based European cohorts, Cox regressions were used to find predictors for AF, HF, subsequent onset, and mortality. Differences between associations were estimated using bootstrapping. Median follow-up time was 13.8 years, with a mortality of 15.7%. AF and HF occurred in 5.0% and 5.4% of the participants, respectively, with 1.8% showing subsequent onset. Age, male sex, myocardial infarction, body mass index, and NT-proBNP (N-terminal pro-B-type natriuretic peptide) showed similar associations with both diseases. Antihypertensive medication and smoking were stronger predictors of HF than AF. Cholesterol, diabetes mellitus, and hsCRP (high-sensitivity C-reactive protein) were associated with HF, but not with AF. No variable was exclusively associated with AF. Population-attributable risks were higher for HF (75.6%) than for AF (30.9%). Age, male sex, body mass index, diabetes mellitus, and NT-proBNP were associated with subsequent onset, which was associated with the highest all-cause mortality risk. Conclusions Common risk factors and biomarkers showed different associations with AF and HF, and explained a higher proportion of HF than AF risk. As the subsequent onset of both diseases was strongly associated with mortality, prevention needs to be rigorously addressed and remains challenging, as conventional risk factors explained only 31% of AF risk.
KW - atrial fibrillation
KW - biomarkers
KW - heart failure
KW - population
KW - risk factors
UR - http://www.scopus.com/inward/record.url?scp=85084272978&partnerID=8YFLogxK
U2 - 10.1161/JAHA.119.015218
DO - 10.1161/JAHA.119.015218
M3 - Journal article
C2 - 32351154
SN - 2047-9980
VL - 9
SP - e015218
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 9
M1 - e015218
ER -