This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (3)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Cardiovascular System  • Women's Health  • Women's Health, Other  • Arrhythmias  • Cardiovascular Disease/ Myocardial Infarction  • Alert me on articles by topic  Social Bookmarking   What's this?

The Rotterdam Study

Jan Heeringa, MD; Deirdre A. M. van der Kuip, MD, PhD; Albert Hofman, MD, PhD; Jan A. Kors, PhD; Frank J. A. van Rooij, MSc; Greg Y. H. Lip, MD, FRCP; Jacqueline C. M. Witteman, PhD

Arch Intern Med. 2007;167(4):382-387.

Background  Myocardial infarction is an important risk factor for atrial fibrillation, but the role of subclinical atherosclerosis is unknown. This longitudinal study evaluates whether atherosclerosis affects the risk of atrial fibrillation in persons without overt coronary disease.

Methods  This investigation was part of the Rotterdam Study, a population-based cohort study among persons 55 years or older. Participants with atrial fibrillation at baseline, with a history of myocardial infarction, or with angina pectoris and those who had undergone cardiac operative procedures were excluded, leaving 4407 subjects for the analyses. Baseline intima-media thickness of the common carotid artery and the presence of carotid plaques were used as indices of generalized atherosclerosis. During a median follow-up of 7.5 years, 269 cases of incident atrial fibrillation were identified. Relative risks were calculated with 95% confidence intervals, adjusted for age and sex, using the Cox proportional hazards model. Additional adjustments were made for body mass index, hypertension, systolic blood pressure, serum cholesterol level, smoking, diabetes mellitus, left ventricular hypertrophy on the electrocardiogram, and the use of cardiac medication.

Results  The risk of atrial fibrillation was associated with carotid intima-media thickness (relative risk, 1.90; 95% confidence interval, 1.20-3.00, highest vs lowest quartile) and severity of carotid plaques (relative risk, 1.49; 95% confidence interval, 1.06-2.10, severe vs absence). Risk estimates were stronger in women than in men.

Conclusions  Atherosclerosis in participants without manifest atherosclerotic disease is an independent risk factor for atrial fibrillation. These results suggest that aggressive treatment of asymptomatic atherosclerosis may help to prevent atrial fibrillation.

Author Affiliations: Departments of Epidemiology and Biostatistics (Drs Heeringa, van der Kuip, Hofman, and Witteman and Mr van Rooij) and Medical Informatics (Dr Kors), Erasmus Medical Center, Rotterdam, the Netherlands; and Haemostasis, Thrombosis, and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, England (Dr Lip).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Atrial fibrillation and heart rate independently correlate to microalbuminuria in hypertensive patients
Bohm et al.
Eur Heart J 2009;30:1364-1371.
ABSTRACT | FULL TEXT  

Risks of cardiovascular events and effects of routine blood pressure lowering among patients with type 2 diabetes and atrial fibrillation: results of the ADVANCE study
Du et al.
Eur Heart J 2009;30:1128-1135.
ABSTRACT | FULL TEXT  

Use of Carotid Intima-Media Thickness to Identify Patients With Ischemic Stroke and Transient Ischemic Attack With Low Yield of Cardiovascular Sources of Embolus on Transesophageal Echocardiography
Ward et al.
Stroke 2008;39:2969-2974.
ABSTRACT | FULL TEXT