Abstract MP007: Higher Plasma Galectin-3 is Associated With Increased Incidence of Atrial Fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Background: Atrial fibrillation (AF) is a common supraventricular tachyarrhythmia associated with increased risk of cardiovascular sequelae, including heart failure (HF), stroke, and premature mortality. Galectin-3, a beta-galactoside binding lectin involved in important regulatory roles in adhesion, inflammation, immunity, and fibrosis, may be relevant to AF etiology. We tested the hypothesis that plasma galectin-3 concentration would be associated positively with the incidence of AF independent of traditional AF risk factors and incident HF and coronary heart disease (CHD) in a large community-based cohort in the US. Methods: Our analysis included 8,777 participants free of AF at visit 4 (1996-98) and with measures of plasma galectin-3 from the biracial Atherosclerosis Risk in Communities (ARIC) study. Incident AF was ascertained through the end of 2013 from study visit ECGs, hospitalizations and death certificates. Multivariable Cox proportional hazards models, adjusted for AF risk factors (Model 1) plus incident HF and CHD (Model 2), were used to estimate hazards ratios for the association between galectin-3 and incident AF. Results: The mean age (SD) of participants was 62.5 (5.6) years; 58.7% were women and 21.5% blacks. During a median follow-up of 15.7 years, 1,233 incident cases of AF were observed. After adjusting for AF risk factors, participants with galectin-3 levels greater than 19.5 ng/ml had a significantly higher risk of incident AF when compared to the referent group (4.4 - 11.9ng/ml), with hazard ratios of 1.44 for the 90 th - 94.9 th percentile, and 1.61 for the 95 th - 100 th percentile (p-trend = 0.0003). The association between galectin-3 concentration and incident AF was attenuated somewhat after accounting for incident CHD and HF as time dependent variables (p-trend=0.03) (Table 1). Conclusion: Elevated plasma galectin-3 is associated independently with increased risk of incident AF.