Department of Cardiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
Europace. 2017 Feb 1;19(2):226-232. doi: 10.1093/europace/euw016.
Atrial fibrillation (AF) may present variously in time, and AF may progress from self-terminating to non-self-terminating AF, and is associated with impaired prognosis. However, predictors of AF types are largely unexplored. We investigate the clinical, biomarker, and genetic predictors of development of specific types of AF in a community-based cohort.
We included 8042 individuals (319 with incident AF) of the PREVEND study. Types of AF were compared, and multivariate multinomial regression analysis determined associations with specific types of AF.
Mean age was 48.5 ± 12.4 years and 50% were men. The types of incident AF were ascertained based on electrocardiograms; 103(32%) were classified as AF without 2-year recurrence, 158(50%) as self-terminating AF, and 58(18%) as non-self-terminating AF. With multivariate multinomial logistic regression analysis, advancing age (P< 0.001 for all three types) was associated with all AF types, male sex was associated with AF without 2-year recurrence and self-terminating AF (P= 0.031 and P= 0.008, respectively). Increasing body mass index and MR-proANP were associated with both self-terminating (P= 0.009 and P< 0.001) and non-self-terminating AF (P= 0.003 and P< 0.001). The only predictor associated with solely self-terminating AF is prescribed anti-hypertensive treatment (P= 0.019). The following predictors were associated with non-self-terminating AF; lower heart rate (P= 0.018), lipid-lowering treatment prescribed (P= 0.009), and eGFR <60 mL/min/1.73 m2 (P= 0.006). Three known AF-genetic variants (rs6666258, rs6817105, and rs10821415) were associated with self-terminating AF.
We found clinical, biomarker and genetic predictors of specific types of incident AF in a community-based cohort. The genetic background seems to play a more important role than modifiable risk factors in self-terminating AF.
心房颤动（AF）可能在不同时间出现，AF 可能从自行终止转变为非自行终止 AF，并与预后不良有关。然而，AF 类型的预测因素在很大程度上尚未得到探索。我们在一个基于社区的队列中研究了临床、生物标志物和遗传因素对特定类型 AF 发展的预测作用。
我们纳入了 PREVEND 研究中的 8042 名个体（319 名发生 AF）。比较了 AF 的类型，并通过多变量多项逻辑回归分析确定了与特定类型 AF 的关联。
平均年龄为 48.5±12.4 岁，50%为男性。根据心电图确定了新发 AF 的类型；103 例（32%）被归类为无 2 年复发的 AF，158 例（50%）为自行终止的 AF，58 例（18%）为非自行终止的 AF。通过多变量多项逻辑回归分析，年龄增长（所有三种类型的 P<0.001）与所有 AF 类型相关，男性与无 2 年复发和自行终止的 AF 相关（P=0.031 和 P=0.008）。体重指数和 MR-proANP 的增加与自行终止（P=0.009 和 P<0.001）和非自行终止的 AF 相关（P=0.003 和 P<0.001）。唯一与单纯自行终止的 AF 相关的预测因素是处方抗高血压治疗（P=0.019）。与非自行终止的 AF 相关的预测因素包括：心率较低（P=0.018）、处方降脂治疗（P=0.009）和 eGFR<60 mL/min/1.73 m2（P=0.006）。三种已知的 AF 遗传变异（rs6666258、rs6817105 和 rs10821415）与自行终止的 AF 相关。
我们在一个基于社区的队列中发现了特定类型新发 AF 的临床、生物标志物和遗传预测因素。遗传背景在自行终止的 AF 中似乎比可改变的危险因素发挥更重要的作用。
