TY - JOUR
T1 - Association of sickle cell trait with atrial fibrillation
T2 - The REGARDS cohort
AU - Douce, Daniel R.
AU - Soliman, Elsayed Z.
AU - Naik, Rakhi
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.
N1 - Funding Information:
This research project is supported by a cooperative agreement from the National Institute of Neurological Disorders and Stroke , National Institutes of Health , Department of Health and Human Services [ U01 NS041588 ]. The authors thank the other investigators, the staff, and the participants of the REGARDS study for their valuable contributions. A full list of participating REGARDS investigators and institutions can be found at http://www.regardsstudy.org . Additional funding was provided by Lake Champlain Cancer Research Organization Inc . Additionally, this project has been funded in part with Federal funds from the Frederick National Laboratory for Cancer Research , National Institutes of Health, under contract [ HHSN261200800001E ]. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the US Government.
Publisher Copyright:
© 2019 Elsevier Inc.
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.
KW - Atrial fibrillation
KW - Sickle cell trait
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U2 - 10.1016/j.jelectrocard.2019.04.010
DO - 10.1016/j.jelectrocard.2019.04.010
M3 - Article
C2 - 31028976
AN - SCOPUS:85064601423
SN - 0022-0736
VL - 55
SP - 1
EP - 5
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
ER -