Brachial Flow-Mediated Dilation and Incident Atrial Fibrillation The Multi-Ethnic Study of Atherosclerosis

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)
Wesley T.,Efird,Jimmy T.,Yeboah,Joseph,Nazarian,Saman,Alo O'Neal (Creator)
East Carolina University (ECU )
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Abstract: Objective-”It is unknown whether endothelial dysfunction precedes atrial fibrillation (AF) development. The objective ofthis study was to examine the association of brachial flow-mediated dilation (FMD) with incident AF.Approach and Results-”A total of 2936 participants (mean age, 61±9.9 years; 50% women; 66% nonwhites) from theMulti-Ethnic Study of Atherosclerosis with available ultrasound brachial FMD measurements who were free of baselineAF were included in this analysis. Baseline (2000--2002) FMD was computed from the percentage difference (%FMD)in brachial artery diameter and maximum diameter during measured vasodilator response. AF was ascertained fromhospitalization data including Medicare claims during a median follow-up of 8.5 years. Probability-weighted Coxproportional-hazards regression was used to compute hazard ratios and 95% confidence intervals for the associationbetween FMD as a continuous variable (%FMD values per 1-SD increase) and incident AF. Incident AF was detected in137 (4.7%) participants. Those with %FMD values below the sex-specific median value (median %FMD; men, 3.6%;women, 4.2%; incidence rate per 1000 person-years, 7.3; 95% confidence interval, 5.9--9.0) were more likely to developAF than people whose %FMD values were above the median value (incidence rate per 1000 person-years, 4.5; 95%confidence interval, 3.4--5.8; log-rank P=0.0043). In a multivariable Cox regression analysis, each 1-SD increase in%FMD values (SD, 2.8%) was associated with less incident AF (hazard ratio, 0.84; 95% confidence interval, 0.70--0.99).These results were consistent across subgroups stratified by age, sex, and race/ethnicity.Conclusions-”Smaller brachial FMD values are associated with higher rates of AF, sugges

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Language: English
Date: 2014
atrial fibrillation endothelium epidemiology

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