Dataset Information

Association of proteinuria with incident atrial fibrillation in the general Japanese population.

ABSTRACT:

Background

Although proteinuria has been associated with incident atrial fibrillation (AF) in Western countries, the association has not been investigated in the general Japanese population.

Methods

Participants aged ≥40 years who underwent the Japanese specific health check-up in Kanazawa City in 2013 and who completed a urine dipstick test were included in this study. Exposure was considered as presence or absence of proteinuria (≥1+). The outcome was incident AF confirmed by 12-lead electrocardiography. The Cox proportional hazard model was used to compute hazard ratio (HR) of proteinuria (≥1+) for incident AF after adjustment for traditional risk factors. We also completed stratified analyses by baseline characteristics.

Results

A total of 37,910 participants aged ≥40 years were included (mean age: 72.3 years, male sex: 37%). Proteinuria ≥1+ was observed in 2.765 (7.3%) participants. During a median follow-up period of 5 years, 708 incident AF cases were observed. Proteinuria ≥1+ was associated with incident AF (HR, 1.47: 95% confidence interval, 1.18-1.84) after covariate adjustment. Stratified analysis demonstrated that the association of proteinuria with AF was stronger in participants <75 years [HR 1.89 (95% CI 1.32-2.70)] compared with those ≥75 years [HR 1.27 (95% CI 0.95-1.69)] (interaction p-value=0.02).

Conclusions

Proteinuria was significantly associated with incident AF in the general Japanese population. The evaluation of proteinuria using urine dipstick test may be useful in the evaluation of incident AF, especially in younger general population.

SUBMITTER: Tanaka Y

PROVIDER: S-EPMC7924545 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundDifferent biological pathways have been related to atrial fibrillation (AF). Novel biomarkers capturing inflammation, oxidative stress, and neurohumoral activation have not been investigated comprehensively in AF.Methods and resultsIn the population-based Gutenberg Health Study (n = 5000), mean age 56 ± 11 years, 51% males, we measured ten biomarkers representing inflammation (C-reactive protein, fibrinogen), cardiac and vascular function (midregional pro adrenomedullin [MR-proADM], midregional pro atrial natriuretic peptide [MR-proANP], N-terminal pro-B-type natriuretic peptide [Nt-proBNP], sensitive troponin I ultra [TnI ultra], copeptin, and C-terminal pro endothelin-1), and oxidative stress (glutathioneperoxidase-1, myeloperoxidase) in relation to manifest AF (n = 161 cases). Individuals with AF were older, mean age 64.9 ± 8.3, and more often males, 71.4%. In Bonferroni-adjusted multivariable regression analyses strongest associations per standard deviation increase in biomarker concentrations were observed for the natriuretic peptides Nt-proBNP (odds ratio [OR] 2.89, 99.5% confidence interval [CI] 2.14-3.90; P<0.0001), MR-proANP (OR 2.45, 99.5% CI 1.91-3.14; P<0.0001), the vascular function marker MR-proADM (OR 1.54, 99.5% CI 1.20-1.99; P<0.0001), TnI ultra (OR 1.50, 99.5% CI 1.19-1.90; P<0.0001) and. fibrinogen (OR 1.44, 99.5% CI 1.19-1.75; P<0.0001). Based on a model comprising known clinical risk factors for AF, all biomarkers combined resulted in a net reclassification improvement of 0.665 (99.3% CI 0.441-0.888) and an integrated discrimination improvement of >13%.ConclusionsIn conclusion, in our large, population-based study, we identified novel biomarkers reflecting vascular function, MR-proADM, inflammation, and myocardial damage, TnI ultra, as related to AF; the strong association of natriuretic peptides was confirmed. Prospective studies need to examine whether risk prediction of AF can be enhanced beyond clinical risk factors using these biomarkers.