Association of sickle cell trait with atrial fibrillation: The REGARDS cohort

Daniel R. Douce, Elsayed Z. Soliman, Rakhi Prakash Naik, Hyacinth I. Hyacinth, Mary Cushman, Cheryl A. Winkler, George Howard, Ethan M. Lange, Leslie A. Lange, Marguerite R. Irvin, Neil A. Zakai

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalJournal of Electrocardiology
Volume55
DOIs
StatePublished - Jul 1 2019

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Sickle Cell Trait
Atrial Fibrillation
Stroke
Sex Education
Sickle Cell Anemia
Chronic Renal Insufficiency
Electrocardiography
Hypertension
Social Adjustment
House Calls
African Americans

Keywords

  • Atrial fibrillation
  • Sickle cell trait

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Douce, D. R., Soliman, E. Z., Naik, R. P., Hyacinth, H. I., Cushman, M., Winkler, C. A., ... Zakai, N. A. (2019). Association of sickle cell trait with atrial fibrillation: The REGARDS cohort. Journal of Electrocardiology, 55, 1-5. https://doi.org/10.1016/j.jelectrocard.2019.04.010

Association of sickle cell trait with atrial fibrillation : The REGARDS cohort. / Douce, Daniel R.; Soliman, Elsayed Z.; Naik, Rakhi Prakash; Hyacinth, Hyacinth I.; Cushman, Mary; Winkler, Cheryl A.; Howard, George; Lange, Ethan M.; Lange, Leslie A.; Irvin, Marguerite R.; Zakai, Neil A.

In: Journal of Electrocardiology, Vol. 55, 01.07.2019, p. 1-5.

Research output: Contribution to journalArticle

Douce, DR, Soliman, EZ, Naik, RP, Hyacinth, HI, Cushman, M, Winkler, CA, Howard, G, Lange, EM, Lange, LA, Irvin, MR & Zakai, NA 2019, 'Association of sickle cell trait with atrial fibrillation: The REGARDS cohort', Journal of Electrocardiology, vol. 55, pp. 1-5. https://doi.org/10.1016/j.jelectrocard.2019.04.010
Douce, Daniel R. ; Soliman, Elsayed Z. ; Naik, Rakhi Prakash ; Hyacinth, Hyacinth I. ; Cushman, Mary ; Winkler, Cheryl A. ; Howard, George ; Lange, Ethan M. ; Lange, Leslie A. ; Irvin, Marguerite R. ; Zakai, Neil A. / Association of sickle cell trait with atrial fibrillation : The REGARDS cohort. In: Journal of Electrocardiology. 2019 ; Vol. 55. pp. 1-5.
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abstract = "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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T1 - Association of sickle cell trait with atrial fibrillation

T2 - The REGARDS cohort

AU - Douce, Daniel R.

AU - Soliman, Elsayed Z.

AU - Naik, Rakhi Prakash

AU - Hyacinth, Hyacinth I.

AU - Cushman, Mary

AU - Winkler, Cheryl A.

AU - Howard, George

AU - Lange, Ethan M.

AU - Lange, Leslie A.

AU - Irvin, Marguerite R.

AU - Zakai, Neil A.

PY - 2019/7/1

Y1 - 2019/7/1

N2 - 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.

AB - 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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KW - Sickle cell trait

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