Relation of circulating liver transaminase concentrations to risk of new-onset atrial fibrillation

Moritz F. Sinner, Na Wang, Caroline S. Fox, Joao Daniel T. Fontes, Michiel Rienstra, Jared W. Magnani, Ramachandran S. Vasan, Audrey H. Calderwood, Michael Pencina, Lisa M. Sullivan, Patrick T. Ellinor, Emelia J. Benjamin

Research output: Contribution to journalArticle

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Abstract

Heart failure, a strong risk factor for atrial fibrillation (AF), is often accompanied by elevated liver transaminases. The aim of this study was to test the hypothesis that elevated transaminases are associated with the risk for incident AF in the community. A total of 3,744 participants (mean age 65 ± 10 years, 56.8% women) from the Framingham Heart Study Original and Offspring cohorts, free of clinical heart failure, were studied. Cox proportional-hazards models adjusted for standard AF risk factors (age, gender, body mass index, systolic blood pressure, electrocardiographic PR interval, antihypertensive treatment, smoking, diabetes, valvular heart disease, and alcohol consumption) were examined to investigate associations between baseline serum transaminase levels (alanine transaminase and aspartate transaminase) and the incidence of AF over up to 10 years (29,099 person-years) of follow-up. During follow-up, 383 subjects developed AF. The 2 transaminases were significantly associated with greater risk for incident AF (hazard ratio expressed per SD of natural logarithmically transformed biomarker: alanine transaminase hazard ratio 1.19, 95% confidence interval 1.07 to 1.32, p = 0.002; aspartate transaminase hazard ratio 1.12, 95% confidence interval 1.01 to 1.24, p = 0.03). The associations between transaminases and AF remained consistent after the exclusion of participants with moderate to severe alcohol consumption. However, when added to known risk factors for AF, alanine transaminase and aspartate transaminase only subtly improved the prediction of AF. In conclusion, elevated transaminase concentrations are associated with increased AF incidence. The mechanisms by which higher mean transaminase concentrations are associated with incident AF remain to be determined.

Original languageEnglish (US)
Pages (from-to)219-224
Number of pages6
JournalAmerican Journal of Cardiology
Volume111
Issue number2
DOIs
StatePublished - Jan 15 2013
Externally publishedYes

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Transaminases
Atrial Fibrillation
Liver
Aspartate Aminotransferases
Alanine Transaminase
Alcohol Drinking
Heart Failure
Confidence Intervals
Blood Pressure
Heart Valve Diseases
Incidence
Proportional Hazards Models
Antihypertensive Agents
Body Mass Index
Biomarkers
Smoking

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Relation of circulating liver transaminase concentrations to risk of new-onset atrial fibrillation. / Sinner, Moritz F.; Wang, Na; Fox, Caroline S.; Fontes, Joao Daniel T.; Rienstra, Michiel; Magnani, Jared W.; Vasan, Ramachandran S.; Calderwood, Audrey H.; Pencina, Michael; Sullivan, Lisa M.; Ellinor, Patrick T.; Benjamin, Emelia J.

In: American Journal of Cardiology, Vol. 111, No. 2, 15.01.2013, p. 219-224.

Research output: Contribution to journalArticle

Sinner, MF, Wang, N, Fox, CS, Fontes, JDT, Rienstra, M, Magnani, JW, Vasan, RS, Calderwood, AH, Pencina, M, Sullivan, LM, Ellinor, PT & Benjamin, EJ 2013, 'Relation of circulating liver transaminase concentrations to risk of new-onset atrial fibrillation', American Journal of Cardiology, vol. 111, no. 2, pp. 219-224. https://doi.org/10.1016/j.amjcard.2012.09.021
Sinner, Moritz F. ; Wang, Na ; Fox, Caroline S. ; Fontes, Joao Daniel T. ; Rienstra, Michiel ; Magnani, Jared W. ; Vasan, Ramachandran S. ; Calderwood, Audrey H. ; Pencina, Michael ; Sullivan, Lisa M. ; Ellinor, Patrick T. ; Benjamin, Emelia J. / Relation of circulating liver transaminase concentrations to risk of new-onset atrial fibrillation. In: American Journal of Cardiology. 2013 ; Vol. 111, No. 2. pp. 219-224.
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AU - Vasan, Ramachandran S.

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