Genetic risk and atrial fibrillation in patients with heart failure

被引：19

作者：

Kloosterman, Marielle ^{[1
]}

Santema, Bernadet T. ^{[1
]}

Roselli, Carolina ^{[1
,2
]}

Nelson, Christopher P. ^{[3
,4
]}

Koekemoer, Andrea ^{[3
,4
]}

Romaine, Simon P. R. ^{[3
,4
]}

Van Gelder, Isabelle C. ^{[1
]}

Lam, Carolyn S. P. ^{[1
,5
]}

Artola, Vicente A. ^{[1
]}

Lang, Chim C. ^{[6
]}

Ng, Leon L. ^{[3
,4
]}

Metra, Marco ^{[7
,9
]}

Anker, Stefan ^{[8
,10
]}

Filippatos, Gerasimos ^{[11
]}

Dickstein, Kenneth ^{[12
]}

Ponikowski, Piotr ^{[13
]}

van der Harst, Pim ^{[1
]}

van der Meer, Peter ^{[1
]}

van Veldhuisen, Dirk J. ^{[1
]}

Benjamin, Emelia J. ^{[14
]}

Voors, Adriaan A. ^{[1
]}

Samani, Nilesh J. ^{[3
,4
]}

Rienstra, Michiel ^{[1
]}

机构：

[1] Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, POB 30-001, NL-9700 RB Groningen, Netherlands

[2] Broad Inst MIT & Harvard, Cardiovasc Dis Initiat, Cambridge, MA 02142 USA

[3] Univ Leicester, Dept Cardiovasc Sci, Leicester, Leics, England

[4] NIHR Leicester Biomed Res Ctr, Leicester, Leics, England

[5] Natl Heart Ctr, Singapore, Singapore

[6] Univ Dundee, Ninewells Hosp & Med Sch, Sch Med Ctr Cardiovasc & Lung Biol, Div Mol & Clin Med, Dundee, Scotland

[7] Univ Brescia, Dept Med & Surg Specialties, Radiol Sci & Publ Hlth, Inst Cardiol, Brescia, Italy

[8] Berlin Inst Hlth Ctr Regenerat Therapies BCRT, Dept Cardiol CVK, Berlin, Germany

[9] German Ctr Cardiovasc Res DZHK, Partner Site Berlin, Berlin, Germany

[10] Charite Univ Med Berlin, Berlin, Germany

[11] Athens Univ Hosp, Athens, Greece

[12] Univ Bergen, Stavanger Univ Hosp, Bergen, Norway

[13] Med Univ, Univ Hosp, Ctr Heart Dis, Dept Heart Dis, Wroclaw, Poland

[14] Boston Univ, Sch Med, Dept Med, Dept Epidemiol,Sch Publ Hlth, Boston, MA 02118 USA

来源：

EUROPEAN JOURNAL OF HEART FAILURE | 2020年 / 22卷 / 03期

关键词：

Atrial fibrillation; Heart failure; Genetic association studies; Single nucleotide polymorphism; Risk factors;

D O I：

10.1002/ejhf.1735

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims To study the association between an atrial fibrillation (AF) genetic risk score with prevalent AF and all-cause mortality in patients with heart failure. Methods and results An AF genetic risk score was calculated in 3759 European ancestry individuals (1783 with sinus rhythm, 1976 with AF) from the BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT-CHF) by summing 97 single nucleotide polymorphism (SNP) alleles (ranging from 0-2) weighted by the natural logarithm of the relative SNP risk from the latest AF genome-wide association study. Further, we assessed AF risk variance explained by additive SNP variation, and performance of clinical or genetic risk factors, and the combination in classifying AF prevalence. AF was classified as AF or atrial flutter (AFL) at baseline electrocardiogram and/or a history of AF or AFL. The genetic risk score was associated with AF after multivariable adjustment. Odds ratio for AF prevalence per 1-unit increase genetic risk score was 2.12 (95% confidence interval 1.84-2.45, P = 2.15 x 10(-24)) in the total cohort, 2.08 (1.72-2.50, P = 1.30 x 10(-14)) in heart failure with reduced ejection fraction (HFrEF) and 2.02 (1.37-2.99, P = 4.37 x 10(-4)) in heart failure with preserved ejection fraction (HFpEF). AF-associated loci explained 22.9% of overall AF SNP heritability. Addition of the genetic risk score to clinical risk factors increased the C-index by 2.2% to 0.721. Conclusions The AF genetic risk score was associated with increased AF prevalence in HFrEF and HFpEF. Genetic variation accounted for 22.9% of overall AF SNP heritability. Addition of genetic risk to clinical risk improved model performance in classifying AF prevalence.

引用

页码：519 / 527

页数：9

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