Association between the cardiovascular health score and new-onset atrial fibrillation

Abstract

To observe the association between the cardiovascular health score and new-onset atrial fibrillation. A total of 95 026 participants who participated the health examination between July 2006 and October 2007 at Kailuan group and without history of atrial fibrillation were selected as the observation cohort. The second, the third and the fourth health examination were performed between July 2008 to October 2009, July 2010 to October 2011, July 2012 to October 2013, respectively.A total of 85 028 participants were included in the final analysis after excluding participants who had new-onset valvular atrial fibrillation and participants lost to follow-up. The participants were divided into 4 subgroups by cardiovascular health score at baseline according to the definition of AHA and cardiovascular health scoring system, namely group of 0-6 points (n=11 103), 7-8 points (n=24 487), 9-10 points (n=32 556), and 11-14 points (n=16 882). The incidence of atrial fibrillation in each subgroup was observed, and the association between cardiovascular health score and risk of new-onset atrial fibrillation was analyzed using multiple Cox regression analysis. A total of 254 participants developed atrial fibrillation during the median of (5.6±1.4) years follow-up. The total incidence of new-onset atrial fibrillation was 0.53/1 000 person-year. The incidence of atrial fibrillation was 0.69/1 000 person-year, 0.60/1 000 person-year, 0.56/1 000 person-year, and 0.30/1 000 person-year, respectively in 0-6 points, 7-8 points, 9-10 points, and 11-14 points subgroups, respectively(P<0.01). After adjustment of age, gender, education level, income, drink, history of myocardial infarction, history of stroke, serum uric acid and C reactive protein level, multiple Cox regression analysis showed that one health score point increase was related to 8% reduction of new onset atrial fibrillation(HR=0.92, 95%CI 0.86-0.99, P<0.05). Compared with the group of 0-6 points group, the risk of atrial fibrillation in the group of 11-14 points group was reduced by 49% (HR=0.51, 95%CI 0.31-0.83, P<0.01). The risk of new-onset atrial fibrillation is reduced in proportion to increase of cardiovascular health score. Clinical Trail Registry: Chinese Clinical Trail Registry, ChiCTR-TNRC-11001489.