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Association of sickle cell trait with atrial fibrillation: The REGARDS cohort
Daniel R Douce1, Elsayed Z Soliman2, Rakhi Naik3
1University of Vermont College of Medicine, Department of Hematology & Oncology, United States of America.
Insights
Sickle cell trait (SCT) is linked to a higher prevalence of atrial fibrillation (AF). This association persists even after accounting for common risk factors, suggesting other underlying mechanisms may be involved.
Area of Science:
- Cardiovascular Medicine
- Genetics
- Epidemiology
Background:
- Sickle cell trait (SCT) is associated with adverse cardiovascular and renal outcomes.
- Atrial fibrillation (AF) prevalence is elevated in sickle cell disease (SCD), but data for SCT is limited.
Purpose of the Study:
- To investigate the association between sickle cell trait (SCT) and atrial fibrillation (AF).
Main Methods:
- The study analyzed African-American participants from the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study.
- Logistic regression was used to assess the association of SCT with prevalent and incident AF, adjusting for multiple covariates.
- Genotyping and ECG data were utilized for participant assessment.
Main Results:
- Among 10,409 participants, 7.5% had SCT and 7.8% had prevalent AF.
- SCT was significantly associated with a higher prevalence of AF (OR 1.32; 95% CI 1.03-1.70) after adjustments.
- The association with incident AF over 9.2 years was similar but not statistically significant (OR 1.25; 95% CI 0.77-2.03).
Conclusions:
- Sickle cell trait (SCT) is independently associated with an increased prevalence of atrial fibrillation (AF).
- The findings suggest potential alternative mechanisms, beyond traditional risk factors like hypertension and chronic kidney disease, contributing to AF risk in individuals with SCT.
Background:
Sickle cell trait (SCT), sickle cell disease's (SCD) carrier status, has been recently associated with worse cardiovascular and renal outcomes. An increased prevalence of atrial fibrillation (AF) is documented in SCD patients; however, studies in individuals with SCT are lacking.
Objectives:
To determine the association of SCT with AF.
Methods:
Among African-American participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study we assessed the association of SCT (by ECG or medical history) with prevalent AF using logistic regression adjusting for age, sex, income, education, history of stroke, myocardial infarction, diabetes, hypertension, and chronic kidney disease. A second evaluation was performed a mean of 9.2 years later among available participants, and the same model was used to test the association of SCT with incident AF.
Results:
In 10,409 participants with baseline ECG data and genotyping, 778 (7.5%) had SCT and 811 (7.8%) had prevalent AF. After adjusting for age, sex, education and income, SCT was associated with AF, OR 1.32 (95% CI 1.03-1.70). The association with incident AF assessed at the second in-home visit with the same adjustments was similar; OR 1.25 (95% CI 0.77-2.03).
Conclusions:
SCT was associated with a higher prevalence of AF and a non-significantly higher incident AF over a 9.2 year period independent of AF risk factors. SCT remained associated with prevalent AF after adjusting for potential factors on the causal pathway such as hypertension and chronic kidney disease suggesting alternate mechanisms for the increased risk.
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