Immunothrombosis and new-onset atrial fibrillation in the general population

Abstract

\n \n \n Atrial fibrillation (AF) is the most common, age-related cardiac arrhythmia. However, the etiology underlying atrial fibrillation is still largely unknown. At the intersection of the innate immune system and hemostasis, immunothrombosis may be a possible cause of atrial remodeling, and therefore be an underlying cause of AF.\n \n \n \n We aim to evaluate the association between markers of immunothrombosis and new-onset AF in the general population\n \n \n \n From 1990 to 2014, we followed 6,174 participants aged 55 and over, free from AF at inclusion. Immunothrombosis factors fibrinogen, von Willebrand factor, ADAMTS13, and neutrophil extracellular traps (NETs) levels were measured at baseline. Participants were followed until either onset of AF, death, loss-to-follow-up, or reaching the end-date of 01–01–2014. Cox proportional hazard modelling was used to calculated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for cardiovascular risk factors.\n \n \n \n We followed 6,174 participants (mean age 69.1 years, 57% women) for a median follow-up time of 12.8 years. 364 men (13.7%, incidence rate 13.0/100 person-years) and 365 women (10.4%, incidence rate 8.9/1000 person-years) developed AF. We found no significant associations between markers of immunothrombosis and new-onset AF after adjusting for cardiovascular risk factors [HR 1.00 (95% CI 0.93–1.08) for fibrinogen, 1.04 (0.97–1.12) for von Willebrand factor, 1.00 (1.00–1.01) for ADAMTS13, and 1.01 (0.94–1.09) for NETs]. Additionally, we found no significant differences in associations between men and women.\n \n \n \n We found no association between markers of immunothrombosis and new-onset AF in the general population. Our findings imply that inflammation and immunothrombosis may be associated with AF by other cardiovascular risk factors or predisposing conditions of AF.\n \n \n \n Type of funding sources: Foundation. Main funding source(s): Netherlands Organization for the Health Research and Development (ZonMw) Erasmus MC Mrace grant\n