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Am Heart J. 2015 Sep;170(3):455-64.e5. doi: 10.1016/j.ahj.2015.06.008. Epub 2015 Jun 14.

Genetic mutations in African patients with atrial fibrillation: Rationale and design of the Study of Genetics of Atrial Fibrillation in an African Population (SIGNAL).

Author information

1
Department of Medicine, Duke University, Durham, NC; Duke Clinical Research Institute and Duke Global Health Institute, Duke University, Durham, NC. Electronic address: gerald.bloomfield@duke.edu.
2
Department of Epidemiology, Brown University School of Public Health, Providence, RI.
3
Division of Medicine, Moi Teaching and Referral Hospital, Eldoret, Kenya; AMPATH Partnership, Eldoret, Kenya.
4
Krannert Institute of Cardiology, Indiana University, Indianapolis, IN; Department of Medicine, Indiana University, Indianapolis, IN.
5
Department of Epidemiology, University of Washington, Seattle, WA.
6
Division of Medicine, Moi Teaching and Referral Hospital, Eldoret, Kenya.
7
Department of Biostatistics, Indiana University School of Medicine, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN.
8
Department of Medicine, Indiana University, Indianapolis, IN; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN.
9
Department of Medicine, Duke University, Durham, NC; Duke Clinical Research Institute and Duke Global Health Institute, Duke University, Durham, NC.
10
Department of Medicine, Indiana University, Indianapolis, IN.
11
Division of Medicine, Moi Teaching and Referral Hospital, Eldoret, Kenya; AMPATH Partnership, Eldoret, Kenya; Department of Medicine, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya.
12
AMPATH Partnership, Eldoret, Kenya; Department of Medicine, Indiana University, Indianapolis, IN; Department of Medicine, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya.

Abstract

BACKGROUND:

There is an urgent need to understand genetic associations with atrial fibrillation in ethnically diverse populations. There are no such data from sub-Saharan Africa, despite the fact that atrial fibrillation is one of the fastest growing diseases. Moreover, patients with valvular heart disease are underrepresented in studies of the genetics of atrial fibrillation.

METHODS:

We designed a case-control study of patients with and without a history of atrial fibrillation in Kenya. Cases with atrial fibrillation included those with and without valvular heart disease. Patients underwent clinical phenotyping and will have laboratory analysis and genetic testing of >240 candidate genes associated with cardiovascular diseases. A 12-month follow-up assessment will determine the groups' morbidity and mortality. The primary analyses will describe genetic and phenotypic associations with atrial fibrillation.

RESULTS:

We recruited 298 participants: 72 (24%) with nonvalvular atrial fibrillation, 78 (26%) with valvular atrial fibrillation, and 148 (50%) controls without atrial fibrillation. The mean age of cases and controls were 53 and 48 years, respectively. Most (69%) participants were female. Controls more often had hypertension (45%) than did those with valvular atrial fibrillation (27%). Diabetes and current tobacco smoking were uncommon. A history of stroke was present in 25% of cases and in 5% of controls.

CONCLUSION:

This is the first study determining genetic associations in valvular and nonvalvular atrial fibrillation in sub-Saharan Africa with a control population. The results advance knowledge about atrial fibrillation and will enhance international efforts to decrease atrial fibrillation-related morbidity.

PMID:
26385028
PMCID:
PMC4575772
DOI:
10.1016/j.ahj.2015.06.008
[Indexed for MEDLINE]
Free PMC Article

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