Epidemiologic Study of Risk Factors and Biomarkers of Atrial Fibrillation

心房颤动危险因素和生物标志物的流行病学研究

• 批准号: 7937071
• 负责人: Alvaro Alonso
• 金额: $ 39.68万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7937071
• 关键词: Activated Partial Thromboplastin Time measurement; Address; Affect; African American; Alcohol consumption; American; Applications Grants; Area; Arrhythmia; Atherosclerosis; Atrial Fibrillation; Biological Markers; Blood Glucose; Blood Pressure; Blood specimen; Body mass index; Brain natriuretic peptide; C-reactive protein; C-terminal; Cardiac; Cardiovascular Diseases; Categories; Clinical; Clinical Research; Code; Collagen Type I; Collection; Communities; Complement; Coronary; Data; Development; Diagnosis; Diastolic blood pressure; EKG P Wave; Electrocardiogram; Epidemiologic Studies; Epidemiology; Ethnic group; Etiology; Fibrinogen; Fibrosis; Functional disorder; Future; Heart Atrium; Heart Valve Diseases; Heart failure; Hemostatic function; Hospitalization; Incidence; Inflammation; Injury; Interstitial Collagenase; Intervention; Knowledge; Life Style; Measures; Medicare claim; Metabolic syndrome; Myocardial; N-terminal; Outcome; PLAB Protein; Participant; Phenotype; Physical activity; Population; Prevention; Preventive; Preventive Medicine; Process; Prospective Studies; Publishing; Pulse Pressure; Race; Research; Risk; Risk Factors; Role; Sampling; Sampling Studies; Series; Smoking; Stretching; Time; Tissue Inhibitor of Metalloproteinase-1; Troponin T; United States; United States Centers for Medicare and Medicaid Services; Visit; Western Europe; Woman; blood lipid; cardiovascular risk factor; case control; clinical practice; cohort; cost; cost effective; follow-up; high risk; indexing; insight; men; novel; systematic review; von Willebrand Factor; waist circumference

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (04): Clinical Research, and specific Challenge Topic, 04- HL-104: Perform secondary analyses of existing data to answer important clinical and preventive medicine research questions. Atrial fibrillation (AF) is the most frequent cardiac arrhythmia in clinical practice. Epidemiologic studies have provided valuable information on risk factors for AF. These results, however, come from a limited set of cohorts of mostly white populations in the United States and Western Europe. Important knowledge gaps exist in our knowledge of AF epidemiology. First, the epidemiology of AF in non-white ethnic groups is not well defined. Second, little information exists on how changes in AF risk factors could affect the future risk of AF. Third, the role of inflammation, fibrosis, atrial stretch, myocardial injury and hemostasis in the incidence of AF is not appropriately understood. We propose to assess risk factors for AF in a bi-racial population, and explore novel risk factors and biomarkers of AF in the context of the Atherosclerosis Risk in Communities (ARIC) cohort. The ARIC cohort comprises a representative sample of 15,792 men and women (27% African-Americans) from 4 US communities examined in 1987-89, and followed up since then. Specifically, we will assess the following aims: (1) to evaluate whether previously described risk factors for AF in whites are associated with AF incidence in the ARIC African-American population and to describe whether changes in previously described risk factors affect the future risk of AF; (2) to study the role of novel cardiovascular risk factors in the incidence of AF. Specifically, we will evaluate biomarkers of inflammation, atrial stretch, myocardial injury, atrial fibrosis and remodeling, and hemostasis. At baseline and in 3 subsequent visits, participants underwent a physical exam, extensive risk factor ascertainment, and collection of blood samples. We will identify incident cases of AF through hospitalization discharges, ECGs conducted in the follow-up and data from Medicare claims, and measure biomarkers for fibrosis in a sample of the study population. A cohort or case-cohort approach, depending on the specific aim, will be used to evaluate the association between risk factors and biomarkers and the risk of AF. This proposal will provide novel information on risk factors for AF, particularly among African-Americans, will contribute decisively to our understanding of the ethiopathogenic processes underlying AF, and will help to inform potential preventive measures in high-risk populations. This proposal will provide new insights into the causes of atrial fibrillation. Particularly, we will try to disentangle the mechanisms explaining the lower incidence of atrial fibrillation in African-Americans, and identify new biomarkers for atrial fibrillation. Results of this proposal will inform development of new treatments and preventive measures for atrial fibrillation.

描述（由申请人提供）：该申请涉及广泛的挑战领域（04）：临床研究，以及特定的挑战主题，04- HL-104：对现有数据进行二次分析，以回答重要的临床和预防医学研究问题。心房颤动（AF）是临床上最常见的心律失常。流行病学研究为房颤的危险因素提供了有价值的信息。然而，这些结果来自于美国和西欧有限的白人人群。我们对房颤流行病学的认识存在重要的知识缺口。首先，非白种人房颤的流行病学尚未明确。其次，关于房颤危险因素的变化如何影响房颤未来风险的信息很少。第三，炎症、纤维化、心房拉伸、心肌损伤和止血在房颤发生率中的作用还没有得到适当的了解。我们建议在双种族人群中评估房颤的危险因素，并在社区动脉粥样硬化风险（ARIC）队列的背景下探索房颤的新危险因素和生物标志物。ARIC队列包括1987-89年来自美国4个社区的15,792名男性和女性（27%的非洲裔美国人）的代表性样本，并从那时起进行了随访。具体而言，我们将评估以下目的：(1)评估先前描述的白人房颤危险因素是否与ARIC非洲裔美国人房颤发病率相关，并描述先前描述的危险因素的变化是否影响房颤的未来风险；(2)研究新型心血管危险因素在房颤发生中的作用。具体而言，我们将评估炎症、心房拉伸、心肌损伤、心房纤维化和重构以及止血等生物标志物。在基线和随后的3次访问中，参与者接受了身体检查、广泛的危险因素确定和血液样本采集。我们将通过住院出院、随访中进行的心电图和医疗保险索赔数据来识别AF事件病例，并在研究人群样本中测量纤维化的生物标志物。根据具体目的，将采用队列或病例队列方法来评估危险因素和生物标志物与房颤风险之间的关系。该建议将提供房颤危险因素的新信息，特别是在非洲裔美国人中，将有助于我们对房颤背后的埃塞俄比亚致病过程的理解，并将有助于告知高危人群的潜在预防措施。这一建议将为房颤的病因提供新的见解。特别是，我们将试图解开解释非洲裔美国人房颤发病率较低的机制，并确定房颤的新生物标志物。这项建议的结果将为房颤的新治疗和预防措施的发展提供信息。

项目成果

Meta-analysis of cohort and case-control studies of type 2 diabetes mellitus and risk of atrial fibrillation.

• DOI: 10.1016/j.amjcard.2011.03.004
• 发表时间: 2011-07-01
• 期刊: AMERICAN JOURNAL OF CARDIOLOGY
• 影响因子: 2.8
• 作者: Huxley, Rachel R.;Filion, Kristian B.;Konety, Suma;Alonso, Alvaro
• 通讯作者: Alonso, Alvaro

Metabolomics and Incidence of Atrial Fibrillation in African Americans: The Atherosclerosis Risk in Communities (ARIC) Study.

• DOI: 10.1371/journal.pone.0142610
• 发表时间: 2015
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Alonso A;Yu B;Qureshi WT;Grams ME;Selvin E;Soliman EZ;Loehr LR;Chen LY;Agarwal SK;Alexander D;Boerwinkle E
• 通讯作者: Boerwinkle E

Cardiac Autonomic Dysfunction and Incidence of Atrial Fibrillation: Results From 20 Years Follow-Up.

心房颤动的心脏自主神经功能障碍和发生率：随访20年。

• DOI: 10.1016/j.jacc.2016.10.059
• 发表时间: 2017-01-24
• 期刊: Journal of the American College of Cardiology
• 影响因子: 24
• 作者: Agarwal SK;Norby FL;Whitsel EA;Soliman EZ;Chen LY;Loehr LR;Fuster V;Heiss G;Coresh J;Alonso A
• 通讯作者: Alonso A

Association of White Blood Cell Count and Differential with the Incidence of Atrial Fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study.

• DOI: 10.1371/journal.pone.0136219
• 发表时间: 2015
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Misialek JR;Bekwelem W;Chen LY;Loehr LR;Agarwal SK;Soliman EZ;Norby FL;Alonso A
• 通讯作者: Alonso A

Circulating levels of liver enzymes and incidence of atrial fibrillation: the Atherosclerosis Risk in Communities cohort.

• DOI: 10.1136/heartjnl-2014-305756
• 发表时间: 2014-10
• 期刊: Heart (British Cardiac Society)
• 作者: Alonso A;Misialek JR;Amiin MA;Hoogeveen RC;Chen LY;Agarwal SK;Loehr LR;Soliman EZ;Selvin E
• 通讯作者: Selvin E