Iribarren Carlos, Chandra Malini, Parikh Rishi V, Sanchez Gabriela, Sam Danny L, Azamian Farima Faith, Cho Hyo-Min, Ding Huanjun, Molloi Sabee, Go Alan S
Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612, USA.
Kaiser Permanente Santa Clara Medical Center, 700 Lawrence Expy, Santa Clara, CA 95051, USA.
Eur Heart J Open. 2023 Feb 28;3(2):oead017. doi: 10.1093/ehjopen/oead017. eCollection 2023 Mar.
The goal of this study was to examine the association of breast arterial calcification (BAC) presence and quantity with incident atrial fibrillation (AF) in a large cohort of post-menopausal women.
We conducted a longitudinal cohort study among women free of clinically overt cardiovascular disease and AF at baseline (between October 2012 and February 2015) when they attended mammography screening. Atrial fibrillation incidence was ascertained using diagnostic codes and natural language processing. Among 4908 women, 354 incident cases of AF (7%) were ascertained after a mean (standard deviation) of 7 (2) years of follow-up. In Cox regression adjusting for a propensity score for BAC, BAC presence vs. absence was not significantly associated with AF [hazard ratio (HR) = 1.12; 95% confidence interval (CI), 0.89-1.42; = 0.34]. However, a significant (a priori hypothesized) age by BAC interaction was found ( = 0.02) such that BAC presence was not associated with incident AF in women aged 60-69 years (HR = 0.83; 95% CI, 0.63-1.15; = 0.26) but was significantly associated with incident AF in women aged 70-79 years (HR = 1.75; 95% CI, 1.21-2.53; = 0.003). No evidence of dose-response relationship between BAC gradation and AF was noted in the entire cohort or in age groups separately.
Our results demonstrate, for the first time, an independent association between BAC and AF in women over age 70 years.
本研究的目的是在一大群绝经后女性中，检查乳腺动脉钙化（BAC）的存在及数量与房颤（AF）发生之间的关联。
我们对在基线时（2012年10月至2015年2月期间）参加乳房X线筛查且无临床明显心血管疾病和房颤的女性进行了一项纵向队列研究。使用诊断编码和自然语言处理确定房颤发病率。在4908名女性中，经过平均（标准差）7（2）年的随访后，确定了354例房颤事件（7%）。在对BAC倾向评分进行调整的Cox回归分析中，BAC的存在与否与房颤无显著关联[风险比（HR）=1.12；95%置信区间（CI），0.89 - 1.42；P = 0.34]。然而，发现了一个显著的（先验假设的）BAC与年龄的交互作用（P = 0.02），即BAC的存在与60 - 69岁女性的房颤事件无关（HR = 0.83；95% CI，0.63 - 1.15；P = 0.26），但与70 - 79岁女性的房颤事件显著相关（HR = 1.75；95% CI，1.21 - 2.53；P = 0.003）。在整个队列或各年龄组中均未发现BAC分级与房颤之间存在剂量反应关系的证据。
我们的结果首次证明，70岁以上女性中BAC与房颤之间存在独立关联。
