Mitral annular calcification and incident atrial fibrillation in the Multi-Ethnic Study of Atherosclerosis

Wesley T. O'Neal, Jimmy T. Efird, Saman Nazarian, Alvaro Alonso, Susan R. Heckbert, Elsayed Z. Soliman

Research output: Contribution to journalArticle

Abstract

Aims The associations of mitral annular calcification (MAC) with atrial fibrillation (AF) risk factors and related outcomes suggest a possible association between MAC and AF. The aim of this study was to examine the association between MAC and AF in a racially and ethnically diverse population. Methods and results This analysis included 6641 participants (mean age 62 ± 10 years; 53% women; 27% Blacks; 22% Hispanics; 12% Chinese-Americans) from the Multi-Ethnic Study of Atherosclerosis (MESA) who were free of clinical cardiovascular disease and AF at baseline. The presence of MAC was defined by cardiac computed tomography (CT) as an Agatston score >0. Atrial fibrillation was ascertained by hospital discharge records and from Medicare claims data until 31 December 2010. Cox regression was used to compute hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association between MAC and AF. At baseline, 619 (9.3%) participants had MAC. Over a median follow-up of 8.5 years, 308 (4.6%) participants developed AF. In a multivariable adjusted model, MAC was associated with an increased risk of AF (HR = 1.9, 95% CI = 1.5, 2.5). This association was consistent across subgroups of age, sex, race/ethnicity (Whites vs. non-Whites), hypertension, diabetes, and left atrial enlargement. The addition of MAC to the Framingham Heart Study and CHARGE AF risk scores for AF improved the C-statistics from 0.769 to 0.776 (P = 0.038) and 0.788 to 0.792 (P = 0.089), respectively. Conclusion The presence of MAC was predictive of incident AF in MESA. Potentially, these findings suggest a usefulness of cardiac CT to identify individuals at risk for AF.

Original languageEnglish (US)
Pages (from-to)358-363
Number of pages6
JournalEuropace
Volume17
Issue number3
DOIs
StatePublished - Jan 27 2015

Fingerprint

Atrial Fibrillation
Atherosclerosis
Tomography
Confidence Intervals
Asian Americans
Hospital Records
Medicare
Hispanic Americans
Cardiovascular Diseases
Hypertension

Keywords

  • Atrial fibrillation
  • Epidemiology
  • Mitral annulus calcification

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

O'Neal, W. T., Efird, J. T., Nazarian, S., Alonso, A., Heckbert, S. R., & Soliman, E. Z. (2015). Mitral annular calcification and incident atrial fibrillation in the Multi-Ethnic Study of Atherosclerosis. Europace, 17(3), 358-363. https://doi.org/10.1093/europace/euu265

Mitral annular calcification and incident atrial fibrillation in the Multi-Ethnic Study of Atherosclerosis. / O'Neal, Wesley T.; Efird, Jimmy T.; Nazarian, Saman; Alonso, Alvaro; Heckbert, Susan R.; Soliman, Elsayed Z.

In: Europace, Vol. 17, No. 3, 27.01.2015, p. 358-363.

Research output: Contribution to journalArticle

O'Neal, WT, Efird, JT, Nazarian, S, Alonso, A, Heckbert, SR & Soliman, EZ 2015, 'Mitral annular calcification and incident atrial fibrillation in the Multi-Ethnic Study of Atherosclerosis', Europace, vol. 17, no. 3, pp. 358-363. https://doi.org/10.1093/europace/euu265
O'Neal, Wesley T. ; Efird, Jimmy T. ; Nazarian, Saman ; Alonso, Alvaro ; Heckbert, Susan R. ; Soliman, Elsayed Z. / Mitral annular calcification and incident atrial fibrillation in the Multi-Ethnic Study of Atherosclerosis. In: Europace. 2015 ; Vol. 17, No. 3. pp. 358-363.
@article{fe4a3524298445849da29706c0bd2180,
title = "Mitral annular calcification and incident atrial fibrillation in the Multi-Ethnic Study of Atherosclerosis",
abstract = "Aims The associations of mitral annular calcification (MAC) with atrial fibrillation (AF) risk factors and related outcomes suggest a possible association between MAC and AF. The aim of this study was to examine the association between MAC and AF in a racially and ethnically diverse population. Methods and results This analysis included 6641 participants (mean age 62 ± 10 years; 53{\%} women; 27{\%} Blacks; 22{\%} Hispanics; 12{\%} Chinese-Americans) from the Multi-Ethnic Study of Atherosclerosis (MESA) who were free of clinical cardiovascular disease and AF at baseline. The presence of MAC was defined by cardiac computed tomography (CT) as an Agatston score >0. Atrial fibrillation was ascertained by hospital discharge records and from Medicare claims data until 31 December 2010. Cox regression was used to compute hazard ratios (HRs) and 95{\%} confidence intervals (95{\%} CIs) for the association between MAC and AF. At baseline, 619 (9.3{\%}) participants had MAC. Over a median follow-up of 8.5 years, 308 (4.6{\%}) participants developed AF. In a multivariable adjusted model, MAC was associated with an increased risk of AF (HR = 1.9, 95{\%} CI = 1.5, 2.5). This association was consistent across subgroups of age, sex, race/ethnicity (Whites vs. non-Whites), hypertension, diabetes, and left atrial enlargement. The addition of MAC to the Framingham Heart Study and CHARGE AF risk scores for AF improved the C-statistics from 0.769 to 0.776 (P = 0.038) and 0.788 to 0.792 (P = 0.089), respectively. Conclusion The presence of MAC was predictive of incident AF in MESA. Potentially, these findings suggest a usefulness of cardiac CT to identify individuals at risk for AF.",
keywords = "Atrial fibrillation, Epidemiology, Mitral annulus calcification",
author = "O'Neal, {Wesley T.} and Efird, {Jimmy T.} and Saman Nazarian and Alvaro Alonso and Heckbert, {Susan R.} and Soliman, {Elsayed Z.}",
year = "2015",
month = "1",
day = "27",
doi = "10.1093/europace/euu265",
language = "English (US)",
volume = "17",
pages = "358--363",
journal = "Europace",
issn = "1099-5129",
publisher = "Oxford University Press",
number = "3",

}

TY - JOUR

T1 - Mitral annular calcification and incident atrial fibrillation in the Multi-Ethnic Study of Atherosclerosis

AU - O'Neal, Wesley T.

AU - Efird, Jimmy T.

AU - Nazarian, Saman

AU - Alonso, Alvaro

AU - Heckbert, Susan R.

AU - Soliman, Elsayed Z.

PY - 2015/1/27

Y1 - 2015/1/27

N2 - Aims The associations of mitral annular calcification (MAC) with atrial fibrillation (AF) risk factors and related outcomes suggest a possible association between MAC and AF. The aim of this study was to examine the association between MAC and AF in a racially and ethnically diverse population. Methods and results This analysis included 6641 participants (mean age 62 ± 10 years; 53% women; 27% Blacks; 22% Hispanics; 12% Chinese-Americans) from the Multi-Ethnic Study of Atherosclerosis (MESA) who were free of clinical cardiovascular disease and AF at baseline. The presence of MAC was defined by cardiac computed tomography (CT) as an Agatston score >0. Atrial fibrillation was ascertained by hospital discharge records and from Medicare claims data until 31 December 2010. Cox regression was used to compute hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association between MAC and AF. At baseline, 619 (9.3%) participants had MAC. Over a median follow-up of 8.5 years, 308 (4.6%) participants developed AF. In a multivariable adjusted model, MAC was associated with an increased risk of AF (HR = 1.9, 95% CI = 1.5, 2.5). This association was consistent across subgroups of age, sex, race/ethnicity (Whites vs. non-Whites), hypertension, diabetes, and left atrial enlargement. The addition of MAC to the Framingham Heart Study and CHARGE AF risk scores for AF improved the C-statistics from 0.769 to 0.776 (P = 0.038) and 0.788 to 0.792 (P = 0.089), respectively. Conclusion The presence of MAC was predictive of incident AF in MESA. Potentially, these findings suggest a usefulness of cardiac CT to identify individuals at risk for AF.

AB - Aims The associations of mitral annular calcification (MAC) with atrial fibrillation (AF) risk factors and related outcomes suggest a possible association between MAC and AF. The aim of this study was to examine the association between MAC and AF in a racially and ethnically diverse population. Methods and results This analysis included 6641 participants (mean age 62 ± 10 years; 53% women; 27% Blacks; 22% Hispanics; 12% Chinese-Americans) from the Multi-Ethnic Study of Atherosclerosis (MESA) who were free of clinical cardiovascular disease and AF at baseline. The presence of MAC was defined by cardiac computed tomography (CT) as an Agatston score >0. Atrial fibrillation was ascertained by hospital discharge records and from Medicare claims data until 31 December 2010. Cox regression was used to compute hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association between MAC and AF. At baseline, 619 (9.3%) participants had MAC. Over a median follow-up of 8.5 years, 308 (4.6%) participants developed AF. In a multivariable adjusted model, MAC was associated with an increased risk of AF (HR = 1.9, 95% CI = 1.5, 2.5). This association was consistent across subgroups of age, sex, race/ethnicity (Whites vs. non-Whites), hypertension, diabetes, and left atrial enlargement. The addition of MAC to the Framingham Heart Study and CHARGE AF risk scores for AF improved the C-statistics from 0.769 to 0.776 (P = 0.038) and 0.788 to 0.792 (P = 0.089), respectively. Conclusion The presence of MAC was predictive of incident AF in MESA. Potentially, these findings suggest a usefulness of cardiac CT to identify individuals at risk for AF.

KW - Atrial fibrillation

KW - Epidemiology

KW - Mitral annulus calcification

UR - http://www.scopus.com/inward/record.url?scp=84924356931&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84924356931&partnerID=8YFLogxK

U2 - 10.1093/europace/euu265

DO - 10.1093/europace/euu265

M3 - Article

C2 - 25341740

AN - SCOPUS:84924356931

VL - 17

SP - 358

EP - 363

JO - Europace

JF - Europace

SN - 1099-5129

IS - 3

ER -