Liu Chang, Sun Yan V, Li Linzi, Collin Lindsay J, Shah Amit J, Alonso Alvaro
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Atlanta VA Healthcare System, Decatur, GA, USA.
medRxiv. 2025 Jul 14:2025.07.12.25331418. doi: 10.1101/2025.07.12.25331418.
BACKGROUND: Black individuals have a lower incidence of atrial fibrillation (AF) than White individuals, despite a higher burden of traditional risk factors. Prior studies have suggested that European genetic ancestry may contribute to this paradox, but findings have been inconsistent. METHODS: We examined the association between European genetic ancestry and incident AF among 6,920 UK Biobank (UKB) participants who self-identified as Black and were free of AF at baseline. European ancestry proportions were estimated by comparing participants to HapMap reference populations and were analyzed both continuously and categorically using Cox proportional hazards models. Non-linear associations were evaluated using flexible hazard ratio spline curves. We then conducted a meta-analysis combining these results with those from the Atherosclerosis Risk in Communities Study, the Cardiovascular Health Study, and the Women's Health Initiative (WHI). RESULTS: During a median follow-up of 13.7 years, 205 (3%) participants developed incident AF. Each 10% increase in European ancestry was nominally associated with increased AF risk (HR 1.07, 95% CI: 0.95-1.20), and individuals in the highest ancestry category had a higher AF incidence rate. Random-effects meta-analysis of all four cohorts yielded a pooled relative risk (RR) of 1.09 (95% CI: 0.99-1.21), with substantial heterogeneity largely driven by the WHI study. Excluding WHI resulted in a pooled estimate (RR 1.14, 95% CI: 1.05-1.23) without heterogeneity. CONCLUSION: Our findings suggest a modest association between European genetic ancestry and increased AF risk among admixed Black individuals. Future studies should confirm these results, explore underlying mechanisms, and assess their clinical implications.
背景:尽管黑人个体传统风险因素负担较高,但房颤(AF)发病率低于白人个体。先前的研究表明欧洲遗传血统可能导致这一矛盾现象,但研究结果并不一致。 方法:我们在6920名英国生物银行(UKB)参与者中研究了欧洲遗传血统与新发房颤之间的关联,这些参与者自我认定为黑人且基线时无房颤。通过将参与者与HapMap参考人群进行比较来估计欧洲血统比例,并使用Cox比例风险模型对其进行连续和分类分析。使用灵活的风险比样条曲线评估非线性关联。然后,我们进行了一项荟萃分析,将这些结果与社区动脉粥样硬化风险研究、心血管健康研究和妇女健康倡议(WHI)的结果相结合。 结果:在中位随访13.7年期间,205名(3%)参与者发生了新发房颤。欧洲血统每增加10%,名义上与房颤风险增加相关(风险比1.07,95%置信区间:0.95 - 1.20),且血统类别最高的个体房颤发病率更高。对所有四个队列进行随机效应荟萃分析得出合并相对风险(RR)为1.09(95%置信区间:0.99 - 1.21),异质性主要由WHI研究驱动。排除WHI后得到无异质性的合并估计值(RR 1.14,95%置信区间:1.05 - 1.23)。 结论:我们的研究结果表明,在混血黑人个体中,欧洲遗传血统与房颤风险增加之间存在适度关联。未来的研究应证实这些结果,探索潜在机制,并评估其临床意义。
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