Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

Association between familial atrial fibrillation and risk of new-onset atrial fibrillation.

Publication ,  Journal Article
Lubitz, SA; Yin, X; Fontes, JD; Magnani, JW; Rienstra, M; Pai, M; Villalon, ML; Vasan, RS; Pencina, MJ; Levy, D; Larson, MG; Ellinor, PT; Benjamin, EJ
Published in: JAMA
November 24, 2010

CONTEXT: Although the heritability of atrial fibrillation (AF) is established, the contribution of familial AF to predicting new-onset AF remains unknown. OBJECTIVE: To determine whether familial occurrence of AF is associated with new-onset AF beyond established risk factors. DESIGN, SETTING, AND PARTICIPANTS: The Framingham Heart Study, a prospective community-based cohort study started in 1948. Original and Offspring Cohort participants were aged at least 30 years, were free of AF at the baseline examination, and had at least 1 parent or sibling enrolled in the study. The 4421 participants in this analysis (mean age, 54 [SD, 13] years; 54% women) were followed up through December 31, 2007. MAIN OUTCOME MEASURES: Incremental predictive value of incorporating different features of familial AF (any familial AF, premature familial AF [onset ≤65 years old], number of affected relatives, and youngest age of onset in a relative) into a risk model for new-onset AF. RESULTS: Across 11,971 examinations during the period 1968-2007, 440 participants developed AF. Familial AF occurred among 1185 participants (26.8%) and premature familial AF occurred among 351 participants (7.9%). Atrial fibrillation occurred more frequently among participants with familial AF than without familial AF (unadjusted absolute event rates of 5.8% and 3.1%, respectively). The association was not attenuated by adjustment for AF risk factors (multivariable-adjusted hazard ratio, 1.40; 95% confidence interval [CI], 1.13-1.74) or reported AF-related genetic variants. Among the different features of familial AF examined, premature familial AF was associated with improved discrimination beyond traditional risk factors to the greatest extent (traditional risk factors, C statistic, 0.842 [95% CI, 0.826-0.858]; premature familial AF, C statistic, 0.846 [95% CI, 0.831-0.862]; P = .004). Modest changes in integrated discrimination improvement were observed with premature familial AF (2.1%). Net reclassification improvement (assessed using 8-year risk thresholds of <5%, 5%-10%, and >10%) did not change significantly with premature familial AF (index statistic, 0.011; 95% CI, -0.021 to 0.042; P = .51), although categoryless net reclassification was improved (index statistic, 0.127; 95% CI, 0.064-0.189; P = .009). CONCLUSIONS: In this cohort, familial AF was associated with an increased risk of AF that was not attenuated by adjustment for AF risk factors including genetic variants. Assessment of premature familial AF was associated with a very slight increase in predictive accuracy compared with traditional risk factors.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

JAMA

DOI

EISSN

1538-3598

Publication Date

November 24, 2010

Volume

304

Issue

20

Start / End Page

2263 / 2269

Location

United States

Related Subject Headings

  • White People
  • United States
  • Risk
  • Middle Aged
  • Male
  • Humans
  • Genetic Predisposition to Disease
  • General & Internal Medicine
  • Female
  • Cohort Studies
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lubitz, S. A., Yin, X., Fontes, J. D., Magnani, J. W., Rienstra, M., Pai, M., … Benjamin, E. J. (2010). Association between familial atrial fibrillation and risk of new-onset atrial fibrillation. JAMA, 304(20), 2263–2269. https://doi.org/10.1001/jama.2010.1690
Lubitz, Steven A., Xiaoyan Yin, João D. Fontes, Jared W. Magnani, Michiel Rienstra, Manju Pai, Mark L. Villalon, et al. “Association between familial atrial fibrillation and risk of new-onset atrial fibrillation.JAMA 304, no. 20 (November 24, 2010): 2263–69. https://doi.org/10.1001/jama.2010.1690.
Lubitz SA, Yin X, Fontes JD, Magnani JW, Rienstra M, Pai M, et al. Association between familial atrial fibrillation and risk of new-onset atrial fibrillation. JAMA. 2010 Nov 24;304(20):2263–9.
Lubitz, Steven A., et al. “Association between familial atrial fibrillation and risk of new-onset atrial fibrillation.JAMA, vol. 304, no. 20, Nov. 2010, pp. 2263–69. Pubmed, doi:10.1001/jama.2010.1690.
Lubitz SA, Yin X, Fontes JD, Magnani JW, Rienstra M, Pai M, Villalon ML, Vasan RS, Pencina MJ, Levy D, Larson MG, Ellinor PT, Benjamin EJ. Association between familial atrial fibrillation and risk of new-onset atrial fibrillation. JAMA. 2010 Nov 24;304(20):2263–2269.
Journal cover image

Published In

JAMA

DOI

EISSN

1538-3598

Publication Date

November 24, 2010

Volume

304

Issue

20

Start / End Page

2263 / 2269

Location

United States

Related Subject Headings

  • White People
  • United States
  • Risk
  • Middle Aged
  • Male
  • Humans
  • Genetic Predisposition to Disease
  • General & Internal Medicine
  • Female
  • Cohort Studies