Association of single and multiple cardiometabolic diseases with atrial fibrillation: a prospective cohort study

Area of Science:

• Cardiology
• Epidemiology
• Public Health

Background:

• Cardiometabolic diseases (CMDs) are known individual risk factors for atrial fibrillation (AF).
• The cumulative impact of multiple coexisting CMDs on AF risk has not been clearly established.
• Understanding this relationship is crucial for risk stratification and prevention strategies.

Purpose of the Study:

• To investigate the association between the number of coexisting cardiometabolic diseases (CMDs) and the risk of developing atrial fibrillation (AF).
• To determine if there is a cumulative, dose-response effect of multiple CMDs on AF risk.

Main Methods:

• Prospective cohort study utilizing UK Biobank data.
• Inclusion of participants with data on CMDs and AF, assessed via self-reported history and electronic health records.
• Analysis using Cox proportional hazard regression models, with adjustments for confounding factors and stratified analyses.

Main Results:

• A cohort of 308,916 participants was analyzed.
• Increased AF risk was observed with 1 (54% increase), 2 (104% increase), and ≥3 (212% increase) CMDs, compared to a reference group (all p<0.001).
• A significant cumulative dose-response relationship was confirmed between the number of CMDs and AF risk (HR: 1.45, p<0.001).

Conclusions:

• Multiple cardiometabolic diseases (CMDs) are associated with a significantly elevated risk of atrial fibrillation (AF).
• A clear cumulative and dose-dependent relationship exists between the burden of CMDs and AF risk.
• These findings highlight the importance of managing multiple CMDs to mitigate AF risk.