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Arterioscler Thromb Vasc Biol. 2013 Nov;33(11):2660-5. doi: 10.1161/ATVBAHA.113.302272. Epub 2013 Sep 12.

Carotid atherosclerosis and incident atrial fibrillation.

Author information

1
From the Department of Neurology, Medical University Innsbruck, Innsbruck, Austria (K.W., R.P., J.W., S.K.); and Department of Internal Medicine, Bruneck Hospital, Bruneck, Italy (G.E., S.W., M.O.).

Abstract

OBJECTIVE:

Atrial fibrillation (AF) and atherosclerotic vascular disease are closely entangled disorders and often coexist. Whether atherosclerosis predisposes to the development of AF has not been fully elucidated.

APPROACH AND RESULTS:

This study was performed within the framework of the Bruneck Study, a population-based survey with near-complete participation (932 of 1000), long-term follow-up (1990-2010), and thorough assessment of AF. The carotid arteries served as a window to systemic atherosclerosis and were scanned every 5 years. Pooled logistic regression and multistate proportional hazards models were used to identify risk predictors of incident AF and effects of AF on mortality. During follow-up, 118 new cases of AF were detected (incidence per 1000 person-years of 8.1; 95% confidence interval, 6.8-9.6). Individuals with atherosclerosis were more likely to develop AF than individuals without (odds ratio, 1.8; 95% confidence interval, 1.1-3.1; P=0.021). This finding applied to women and men and to both baseline and incident atherosclerosis during follow-up. Subjects with atherosclerosis and AF were significantly more likely to die than those with either condition alone (P=0.0034), and mortality in this group was ≈ 4-fold compared with individuals free of atherosclerosis and AF (hazard ratio, 4.2; 95% confidence interval, 2.6-6.8; P<0.0001).

CONCLUSIONS:

We found that subjects with carotid atherosclerosis are at high risk of developing AF.

KEYWORDS:

atherosclerosis; atrial fibrillation; epidemiology; population; prognosis

PMID:
24030550
DOI:
10.1161/ATVBAHA.113.302272
[Indexed for MEDLINE]

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