TY - JOUR
T1 - Relation of circulating liver transaminase concentrations to risk of new-onset atrial fibrillation
AU - Sinner, Moritz F.
AU - Wang, Na
AU - Fox, Caroline S.
AU - Fontes, João D.
AU - Rienstra, Michiel
AU - Magnani, Jared W.
AU - Vasan, Ramachandran S.
AU - Calderwood, Audrey H.
AU - Pencina, Michael
AU - Sullivan, Lisa M.
AU - Ellinor, Patrick T.
AU - Benjamin, Emelia J.
N1 - Funding Information:
This work was supported by Grants N01-HC25195 and 6R01-NS17950 , Grant 1RO1HL092577 to Dr. Benjamin and Dr. Ellinor, Grants 1RC1HL101056 , 1R01HL102214 , and 1R01AG028321 to Dr. Benjamin, Grants 5R21DA027021 , 1RO1HL104156 , and 1K24HL105780 to Dr. Ellinor, and Grant 1K08DK090150-01 to Dr. Calderwood from the National Institutes of Health , Bethesda, Maryland; by the German Heart Foundation , Frankfurt-am-Main, Germany (to Dr. Sinner); by Grant 09FTF2190028 to Dr. Magnani from the American Heart Association , Dallas, Texas; and partially by the Evans Center for Interdisciplinary Biomedical Research ( http://www.bumc.bu.edu/evanscenteribr/ ) ARC on Atrial Fibrillation at Boston University, Boston, Massachusetts (to Drs. Benjamin and Magnani).
PY - 2013/1/15
Y1 - 2013/1/15
N2 - 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.
AB - 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.
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U2 - 10.1016/j.amjcard.2012.09.021
DO - 10.1016/j.amjcard.2012.09.021
M3 - Article
C2 - 23127690
AN - SCOPUS:84872045804
SN - 0002-9149
VL - 111
SP - 219
EP - 224
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 2
ER -