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Open Access 01-01-2022 | Atrial Fibrillation | Original Paper

Immunothrombosis and new-onset atrial fibrillation in the general population: the Rotterdam Study

Authors: Martijn J. Tilly, Sven Geurts, Samantha J. Donkel, M. Arfan Ikram, Natasja M. S. de Groot, Moniek P. M. de Maat, Maryam Kavousi

Published in: Clinical Research in Cardiology | Issue 1/2022

Abstract

Background

Atrial fibrillation (AF) is the most common age-related cardiac arrhythmia. The etiology underlying AF 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.

Methods

From 1990 to 2014, we followed 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, loss-to-follow-up, or reaching the end-date of 01-01-2014. Cox proportional hazard modelling was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for cardiovascular risk factors.

Results

We followed 6174 participants (mean age 69.1 years, 57% women) for a median follow-up time of 12.8 years. 364 men (13.7%, incidence rate 13.0/1000 person-years) and 365 women (10.4%, incidence rate 8.9/1000 person-years) developed AF. We found no significant association 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]. In addition, we found no differences in associations between men and women.

Conclusion

We found no associations between markers of immunothrombosis and new-onset AF in the general population. Inflammation and immunothrombosis may be associated with AF through other cardiovascular risk factors or predisposing conditions of AF. Our findings challenge the added value of biomarkers in AF risk prediction.

Graphic abstract

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Title: Immunothrombosis and new-onset atrial fibrillation in the general population: the Rotterdam Study
Authors: Martijn J. Tilly
Sven Geurts
Samantha J. Donkel
M. Arfan Ikram
Natasja M. S. de Groot
Moniek P. M. de Maat
Maryam Kavousi
Publication date: 01-01-2022
Publisher: Springer Berlin Heidelberg
Keyword: Atrial Fibrillation
Published in: Clinical Research in Cardiology / Issue 1/2022
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-021-01938-4

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Immunothrombosis and new-onset atrial fibrillation in the general population: the Rotterdam Study

Abstract

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