Top

Published in:

01-06-2011 | Cardiovascular Disease

Inflammation-sensitive proteins and risk of atrial fibrillation: a population-based cohort study

Authors: Samuel Adamsson Eryd, J. Gustav Smith, Olle Melander, Bo Hedblad, Gunnar Engström

Published in: European Journal of Epidemiology | Issue 6/2011

Abstract

Low-grade inflammation has been repeatedly associated with cardiovascular diseases but the relationship with incidence of atrial fibrillation (AF) remains unclear. We explored the association between elevated plasma levels of inflammation-sensitive proteins (ISPs) and incidence of AF in a population-based cohort. Plasma levels of five ISPs (fibrinogen, haptoglobin, ceruloplasmin, α₁-antitrypsin and orosomucoid) and two complement factors (C3 and C4) were measured in 6,031 men (mean age 46.8 years) without history of myocardial infarction, heart failure, stroke or cancer. Incidence of hospitalizations due to AF during a mean follow-up of 25 years was studied both in relation to individual inflammatory proteins and the number of elevated ISPs. During follow-up, 667 patients were hospitalized with a diagnosis of AF. After adjustment for potential confounding factors, the hazard ratios (HR) for AF were 1.00 (reference), 1.08 (95% CI: 0.88–1.31), 1.07 (CI: 0.84–1.36), and 1.40 (CI: 1.12–1.74), respectively, in men with none, one, two and three or more ISPs in the 4th quartile (P for trend = 0.007). Ceruloplasmin was the only individual ISP significantly associated with incidence of AF after adjustment for confounding factors (HR 1.17 per standard deviation, 95% CI: 1.08–1.26). In conclusion, a score of five ISPs was associated with long-term incidence of hospitalizations due to AF in middle-aged men. Of the individual ISPs, a significant association was observed for ceruloplasmin, a protein previously associated with copper metabolism and oxidative stress.

Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the anti coagulation and risk factors in atrial fibrillation (ATRIA) study. JAMA. 2001;285(18):2370–5.PubMedCrossRef

Miyasaka Y, Barnes ME, Gersh BJ, Cha SS, Bailey KR, Abhayaratna WP, et al. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation. 2006;114(2):119–25.PubMedCrossRef

Wolf PA, Benjamin EJ, Belanger AJ, Kannel WB, Levy D, D’Agostino RB. Secular trends in the prevalence of atrial fibrillation: the Framingham study. Am Heart J. 1996;131(4):790–5.PubMedCrossRef

Kannel WB, Benjamin EJ. Current perceptions of the epidemiology of atrial fibrillation. Cardiol Clin. 2009;27(1):13–24.PubMedCrossRef

Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Vasan RS, et al. Lifetime risk for development of atrial fibrillation: the Framingham heart study. Circulation. 2004;110(9):1042–6.PubMedCrossRef

Benjamin EJ, Levy D, Vaziri SM, D’Agostino RB, Belanger AJ, Wolf PA. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham heart study. JAMA. 1994;271(11):840–4.PubMedCrossRef

Psaty BM, Manolio TA, Kuller LH, Kronmal RA, Cushman M, Fried LP, et al. Incidence of and risk factors for atrial fibrillation in older adults. Circulation. 1997;96(7):2455–61.PubMed

Smith JG, Platonov PG, Hedblad B, Engstrom G, Melander O. Atrial fibrillation in the Malmo diet and cancer study: a study of occurrence, risk factors and diagnostic validity. Eur J Epidemiol. 2010;25(2):95–102.PubMedCrossRef

Engstrom G, Lind P, Hedblad B, Stavenow L, Janzon L, Lindgarde F. Effects of cholesterol and inflammation-sensitive plasma proteins on incidence of myocardial infarction and stroke in men. Circulation. 2002;105(22):2632–7.PubMedCrossRef

10.

Koenig W. Fibrin(ogen) in cardiovascular disease: an update. Thromb Haemost. 2003;89(4):601–9.PubMed

11.

Danesh J, Wheeler JG, Hirschfield GM, Eda S, Eiriksdottir G, Rumley A, et al. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med. 2004;350(14):1387–97.PubMedCrossRef

12.

Lowe GD. Circulating inflammatory markers and risks of cardiovascular and non-cardiovascular disease. J Thromb Haemost. 2005;3(8):1618–27.PubMedCrossRef

13.

Danesh J, Lewington S, Thompson SG, Lowe GD, Collins R, Kostis JB, et al. Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis. JAMA. 2005;294(14):1799–809.PubMedCrossRef

14.

Issac TT, Dokainish H, Lakkis NM. Role of inflammation in initiation and perpetuation of atrial fibrillation: a systematic review of the published data. J Am Coll Cardiol. 2007;50(21):2021–8.PubMedCrossRef

15.

Aviles RJ, Martin DO, Apperson-Hansen C, Houghtaling PL, Rautaharju P, Kronmal RA, et al. Inflammation as a risk factor for atrial fibrillation. Circulation. 2003;108(24):3006–10.PubMedCrossRef

16.

Schnabel RB, Larson MG, Yamamoto JF, Sullivan LM, Pencina MJ, Meigs JB, et al. Relations of biomarkers of distinct pathophysiological pathways and atrial fibrillation incidence in the community. Circulation. 2010;121(2):200–7.PubMedCrossRef

17.

Dernellis J, Panaretou M. Effects of C-reactive protein and the third and fourth components of complement (C3 and C4) on incidence of atrial fibrillation. Am J Cardiol. 2006;97(2):245–8.PubMedCrossRef

18.

Schnabel RB, Larson MG, Yamamoto JF, Kathiresan S, Rong J, Levy D, et al. Relation of multiple inflammatory biomarkers to incident atrial fibrillation. Am J Cardiol. 2009;104(1):92–6.PubMedCrossRef

19.

Engstrom G, Hedblad B, Tyden P, Lindgarde F. Inflammation-sensitive plasma proteins are associated with increased incidence of heart failure: a population-based cohort study. Atherosclerosis. 2009;202(2):617–22.PubMedCrossRef

20.

Engstrom G, Stavenow L, Hedblad B, Lind P, Eriksson KF, Janzon L, et al. Inflammation-sensitive plasma proteins, diabetes, and mortality and incidence of myocardial infarction and stroke: a population-based study. Diabetes. 2003;52(2):442–7.PubMedCrossRef

21.

Kristenson H, Trell E. Indicators of alcohol consumption: comparisons between a questionnaire (Mm-MAST), interviews and serum gamma-glutamyl transferase (GGT) in a health survey of middle-aged males. Br J Addict. 1982;77(3):297–304.PubMedCrossRef

22.

Laurell CB. Electroimmuno assay. Scand J Clin Lab Invest Suppl. 1972;124:21–37.PubMedCrossRef

23.

Engstrom G, Hedblad B, Eriksson KF, Janzon L, Lindgarde F. Complement C3 is a risk factor for the development of diabetes: a population-based cohort study. Diabetes. 2005;54(2):570–5.PubMedCrossRef

24.

Smith JG, Newton-Cheh C, Almgren P, Struck J, Morgenthaler NG, Bergmann A, et al. Assessment of conventional cardiovascular risk factors and multiple biomarkers for the prediction of incident heart failure and atrial fibrillation. J Am Coll Cardiol. 2010;56(21):1712–9.PubMedCrossRef

25.

Waldo AL, Feld GK. Inter-relationships of atrial fibrillation and atrial flutter mechanisms and clinical implications. J Am Coll Cardiol. 2008;51(8):779–86.PubMedCrossRef

26.

Marott SC, Nordestgaard BG, Zacho J, Friberg J, Jensen GB, Tybjaerg-Hansen A, et al. Does elevated C-reactive protein increase atrial fibrillation risk? A Mendelian randomization of 47,000 individuals from the general population. J Am Coll Cardiol. 2010;56(10):789–95.PubMedCrossRef

27.

Ehrenwald E, Chisolm GM, Fox PL. Intact human ceruloplasmin oxidatively modifies low density lipoprotein. J Clin Invest. 1994;93(4):1493–501.PubMedCrossRef

28.

Ryden L. In: Lontie R, editor. Copper proteins and copper enzymes. Boca Raton, Florida: CRC Press; 1984. pp. 37–100.

29.

Turnlund JR, Jacob RA, Keen CL, Strain JJ, Kelley DS, Domek JM, et al. Long-term high copper intake: effects on indexes of copper status, antioxidant status, and immune function in young men. Am J Clin Nutr. 2004;79(6):1037–44.PubMed

30.

Mihm MJ, Yu F, Carnes CA, Reiser PJ, McCarthy PM, Van Wagoner DR, et al. Impaired myofibrillar energetics and oxidative injury during human atrial fibrillation. Circulation. 2001;104(2):174–80.PubMed

31.

Ozaydin M, Peker O, Erdogan D, Kapan S, Turker Y, Varol E, et al. N-acetylcysteine for the prevention of postoperative atrial fibrillation: a prospective, randomized, placebo-controlled pilot study. Eur Heart J. 2008;29(5):625–31.PubMedCrossRef

32.

Neuman RB, Bloom HL, Shukrullah I, Darrow LA, Kleinbaum D, Jones DP, et al. Oxidative stress markers are associated with persistent atrial fibrillation. Clin Chem. 2007;53(9):1652–7.PubMedCrossRef

33.

Ellinor PT, Low A, Patton KK, Shea MA, MacRae CA. C-reactive protein in lone atrial fibrillation. Am J Cardiol. 2006;97(9):1346–50.PubMedCrossRef

34.

Pan M, Zhu JH, Jiang WP, Liu ZH, Li HM, Yu XH, et al. Inflammation: a possible pathogenic link to atrial fibrillation. Med Hypotheses. 2006;67(6):1305–7.PubMedCrossRef

35.

Frustaci A, Chimenti C, Bellocci F, Morgante E, Russo MA, Maseri A. Histological substrate of atrial biopsies in patients with lone atrial fibrillation. Circulation. 1997;96(4):1180–4.PubMed

36.

Nakamura Y, Nakamura K, Fukushima-Kusano K, Ohta K, Matsubara H, Hamuro T, et al. Tissue factor expression in atrial endothelia associated with nonvalvular atrial fibrillation: possible involvement in intracardiac thrombogenesis. Thromb Res. 2003;111(3):137–42.PubMedCrossRef

37.

Conen D, Osswald S, Albert CM. Epidemiology of atrial fibrillation. Swiss Med Wkly. 2009;139(25–26):346–52.PubMed

38.

Engstrom G, Janzon L, Berglund G, Lind P, Stavenow L, Hedblad B, et al. Blood pressure increase and incidence of hypertension in relation to inflammation-sensitive plasma proteins. Arterioscler Thromb Vasc Biol. 2002;22(12):2054–8.PubMedCrossRef

39.

Engstrom G, Hedblad B, Stavenow L, Lind P, Janzon L, Lindgarde F. Inflammation-sensitive plasma proteins are associated with future weight gain. Diabetes. 2003;52(8):2097–101.PubMedCrossRef

40.

Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, et al. Guidelines for the management of atrial fibrillation: the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010;31(19):2369–429.

41.

Wood AM, White I, Thompson SG, Lewington S, Danesh J. Regression dilution methods for meta-analysis: assessing long-term variability in plasma fibrinogen among 27,247 adults in 15 prospective studies. Int J Epidemiol. 2006;35(6):1570–8.PubMedCrossRef

Title: Inflammation-sensitive proteins and risk of atrial fibrillation: a population-based cohort study
Authors: Samuel Adamsson Eryd
J. Gustav Smith
Olle Melander
Bo Hedblad
Gunnar Engström
Publication date: 01-06-2011
Publisher: Springer Netherlands
Published in: European Journal of Epidemiology / Issue 6/2011
Print ISSN: 0393-2990
Electronic ISSN: 1573-7284
DOI: https://doi.org/10.1007/s10654-011-9565-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Inflammation-sensitive proteins and risk of atrial fibrillation: a population-based cohort study

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 6/2011

Rebuilding bridges: what is the real role of social class in disease occurrence?

Maternal smoking during pregnancy and risks of suicidal acts in young offspring

Alcohol intake and risk of acute coronary syndrome and mortality in men and women with and without hypertension

The Mayo Lung Project lung cancer mortality findings are unlikely to be biased by a volunteer effect

Influence of common variants in FTO and near INSIG2 and MC4R on growth curves for adiposity in African– and European–American youth

Informativeness of indices of blood pressure, obesity and serum lipids in relation to ischaemic heart disease mortality: the HUNT-II study