Abstract
BackgroundThe cellular adhesion pathway has been suggested as playing an important role in the pathogenesis of atrial fibrillation (AF). However, prior studies that have investigated the role of adhesion pathway proteins in risk of AF have been limited in the number of proteins that were studied and in the ethnic and racial diversity of the study population. Therefore we aimed to study the associations of fifteen adhesion pathway proteins with incident AF in a large, diverse population.MethodsMulti-Ethnic Study of Atherosclerosis participants from four races/ethnicities (n = 2504) with protein levels measured were followed for incident AF (n = 253). HGF protein was measured on Exam 1 samples (N = 6669; AF n = 851). Cox proportional hazards regression was used to assess the association of AF with 15 adhesion pathway proteins. Bonferroni correction was applied to account for multiple comparisons.ResultsAfter adjusting for potential confounding variables (age, sex, race/ethnicity, height, body mass index, systolic blood pressure, antihypertension therapy, diabetes status, current smoker, current alcohol use, and total and HDL cholesterol), and accounting for multiple testing (P < 0.05/15 = 0.0033), circulating levels of the following proteins were positively associated with a higher risk of AF: MMP-2 (HR per standard deviation increment, 1.27; 95% CI 1.11‒1.45), TIMP-2 (HR 1.28; 95% CI 1.12‒1.46), VCAM-1 (HR 1.32; 95% CI 1.16‒1.50), and SLPI (HR 1.22; 95% CI 1.07‒1.38). The association between proteins and AF did not differ by race/ethnicity.ConclusionsCirculating levels of MMP-2, TIMP-2, VCAM-1, and SLPI were positively associated with an increased risk of incident AF in a diverse population. Our findings suggest that adhesion pathway proteins may be important risk predictors of AF.
Highlights
The cellular adhesion pathway has been suggested as playing an important role in the pathogenesis of atrial fibrillation (AF)
Heart failure was added to Model 2 as a time-dependent variable as events occurred during follow-up to assess whether it was a plausible mediator in the association between proteins and incident AF
After adjustment for age, sex, and race/ethnicity, matrix metalloproteinase 2 (MMP-2), tissue inhibitor of metalloproteinase 2 (TIMP-2), vascular cell adhesion molecule 1 (VCAM-1), Hepatocyte growth factor (HGF), secretory leukocyte protease inhibitor (SLPI), and IL-2 Interleukin soluble receptor (sR) were associated with a higher risk of AF with each standard deviation increase in protein level (P < 0.0033; Table 3)
Summary
The cellular adhesion pathway has been suggested as playing an important role in the pathogenesis of atrial fibrillation (AF). We aimed to study the associations of fifteen adhesion pathway proteins with incident AF in a large, diverse population. The Framingham Offspring Study assessed the association of 12 circulating inflammatory markers and found that circulating osteoprotegerin was associated with incident AF [6].there is growing evidence that the cellular adhesion pathway, a biological pathway of inflammation, may play a role in AF. In the Women’s Health Study, markers of systemic inflammation, including high sensitivity C-reactive protein (CRP), soluble intercellular adhesion molecule-1 (ICAM-1), and fibrinogen, were significantly associated with AF [7]. A prospective, population-based cohort study that studied thirteen inflammation markers found that the vascular cell adhesion molecule 1 (VCAM-1) was significantly associated with new-onset AF in the general community [8]
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