Burden of cardiometabolic disorders and lifetime risk of new-onset atrial fibrillation among men and women: the...

Area of Science:

• Cardiology
• Epidemiology
• Public Health

Background:

• Cardiometabolic disorders are a growing public health concern.
• Atrial fibrillation (AF) is a common arrhythmia with significant morbidity.
• Understanding the interplay between cardiometabolic health and AF risk is crucial.

Purpose of the Study:

• To investigate the association between the burden of cardiometabolic disorders and new-onset atrial fibrillation (AF).
• To evaluate the lifetime risk of AF incidence based on the number of cardiometabolic disorders in men and women.

Main Methods:

• Population-based Rotterdam Study cohort including 4,101 men and 5,421 women without AF at baseline.
• Sex-specific Cox proportional-hazards regression models to assess AF risk.
• Estimation of remaining lifetime risk for AF at ages 55, 65, and 75.

Main Results:

• A stronger association between cardiometabolic disorder burden and incident AF was observed in women (HR: 1.33) compared to men (HR: 1.18).
• The lifetime risk of AF significantly increased with the number of cardiometabolic disorders in both sexes.
• At age 55, lifetime AF risks ranged from 27.1% (0 disorders) to 33.3% (≥4 disorders) in men, and 15.8% (0 disorders) to 34.2% (≥4 disorders) in women.

Conclusions:

• Cardiometabolic multimorbidity significantly impacts AF risk, with a pronounced effect in women.
• Individuals with multiple cardiometabolic disorders have a substantially higher lifetime risk of developing AF.
• This risk is particularly elevated when assessed at younger index ages.