TY - JOUR
T1 - Risk Factors, Subsequent Disease Onset, and Prognostic Impact of Myocardial Infarction and Atrial Fibrillation
AU - Camen, Stephan
AU - Csengeri, Dora
AU - Geelhoed, Bastiaan
AU - Niiranen, Teemu
AU - Gianfagna, Francesco
AU - Vishram-Nielsen, Julie K.
AU - Costanzo, Simona
AU - Söderberg, Stefan
AU - Vartiainen, Erkki
AU - Börschel, Christin S.
AU - Donati, Maria Benedetta
AU - Løchen, Maja-Lisa
AU - Ojeda, Francisco M.
AU - Kontto, Jukka
AU - Mathiesen, Ellisiv B.
AU - Jensen, Steen
AU - Koenig, Wolfgang
AU - Kee, Frank
AU - de Gaetano, Giovanni
AU - Zeller, Tanja
AU - Jørgensen, Torben
AU - Tunstall-Pedoe, Hugh
AU - Blankenberg, Stefan
AU - Kuulasmaa, Kari
AU - Linneberg, Allan
AU - Salomaa, Veikko
AU - Iacoviello, Licia
AU - Schnabel, Renate B.
N1 - Funding Information:
The MORGAM (Monica Risk, Genetics, Archiving and Monograph) project has received funding from European Union (EU) projects MORGAM (Biomed, BMH4-CT98-3183), GenomEUtwin (FP5, QLG2-CT-2002-01254), ENGAGE (FP7, HEALTH-F4-2007-201413), CHANCES (FP7, HEALTH-F3-010-242244), BiomarCaRE (Biomarker for Cardiovascular Risk Assessment Across Europe; FP7, HEALTH-F2-2011-278913), euCanSHare (Horizon 2020, No. 825903), and AFFECT-EU (Horizon 2020; 847770) and Medical Research Council, London (G0601463; 80983: Biomarkers in the MORGAM Populations). This has supported central coordination, workshops, and part of the activities of the MORGAM Data Centre, the MORGAM Laboratories, and the MORGAM Participating Centres. Dr Schnabel has received funding from the European Research Council under the European Union’s Horizon 2020 research and innovation program (648131), from the European Union’s Horizon 2020 research and innovation program under the Grant Agreement o. 847770 (AFFECT-EU) and German Center for Cardiovascular Research (DZHK e.V.; 81Z1710103), German Ministry of Research and Education (BMBF 01ZX1408A), and ERACoSysMed3 (031L0239). The FINRISK surveys were mainly supported by budgetary funds of THL with additional funding from numerous nonprofit foundations. Dr Salomaa has been supported by the Finnish Foundation for Cardiovascular Research and the Academy of Finland (139635). Dr Niiranen has been supported by the Finnish Foundation for Cardiovascular Research, the Finnish Medical Foundation, the Emil Aaltonen Foundation, and the Academy of Finland (321351). The DANMONICA cohorts at the Research Center for Prevention and Health (currently named Centre for Clinical Research and Prevention) were established during a period of 10 years and have been funded by numerous sources that have been acknowledged, where appropriate, in the original articles. The Moli-sani Project was partially supported by research grants from the Pfizer Foundation (Rome, Italy), the Italian Ministry of University and Research (MIUR, Rome, Italy)–Programma Triennale di Ricerca, Decreto No. 1588 and Instrumentation Laboratory, Milan, Italy. The Northern Sweden MONICA project was supported by Norrbotten and Västerbotten County Councils. Dr Söderberg has been supported by the Swedish Heart–Lung Foundation (20140799, 20120631, 20100635), the County Council of Västerbotten (ALF, VLL-548791), and Umeå University. The SHHEC (Scottish Heart Health Extended Cohort) received funding from the Scottish Health Department Chief Scientist Organization, the British Heart Foundation, and the FP Fleming Trust. The Tromsø Study was supported by the UiT Arctic University of Norway, the municipality of Tromsø, the Norwegian Research Council, and the National Health Screening Service.
PY - 2022/4/5
Y1 - 2022/4/5
N2 - Background: Although myocardial infarction (MI) and atrial fibrillation (AF) are frequent comorbidities and share common cardiovascular risk factors, the direction and strength of the association of the risk factors with disease onset, subsequent disease incidence, and mortality are not completely understood.Methods and Results: In pooled multivariable Cox regression analyses, we examined temporal relations of disease onset and identified predictors of MI, AF, and all-cause mortality in 108 363 individuals (median age, 46.0 years; 48.2% men) free of MI and AF at baseline from 6 European population-based cohorts. During a maximum follow-up of 10.0 years, 3558 (3.3%) individuals were diagnosed exclusively with MI, 1922 (1.8%) with AF but no MI, and 491 (0.5%) individuals developed both MI and AF. Association of sex, systolic blood pressure, antihypertensive treatment, and diabetes appeared to be stronger with incident MI than with AF, whereas increasing age and body mass index showed a higher risk for incident AF. Total cholesterol and daily smoking were significantly related to incident MI but not AF. Combined population attributable fraction of cardiovascular risk factors was >70% for incident MI, whereas it was only 27% for AF. Subsequent MI after AF (hazard ratio [HR], 1.68; 95% CI, 1.03-2.74) and subsequent AF after MI (HR, 1.75; 95% CI, 1.31-2.34) both significantly increased overall mortality risk.Conclusions: We observed different associations of cardiovascular risk factors with both diseases indicating distinct pathophysiological pathways. Subsequent diagnoses of MI and AF significantly increased mortality risk.
AB - Background: Although myocardial infarction (MI) and atrial fibrillation (AF) are frequent comorbidities and share common cardiovascular risk factors, the direction and strength of the association of the risk factors with disease onset, subsequent disease incidence, and mortality are not completely understood.Methods and Results: In pooled multivariable Cox regression analyses, we examined temporal relations of disease onset and identified predictors of MI, AF, and all-cause mortality in 108 363 individuals (median age, 46.0 years; 48.2% men) free of MI and AF at baseline from 6 European population-based cohorts. During a maximum follow-up of 10.0 years, 3558 (3.3%) individuals were diagnosed exclusively with MI, 1922 (1.8%) with AF but no MI, and 491 (0.5%) individuals developed both MI and AF. Association of sex, systolic blood pressure, antihypertensive treatment, and diabetes appeared to be stronger with incident MI than with AF, whereas increasing age and body mass index showed a higher risk for incident AF. Total cholesterol and daily smoking were significantly related to incident MI but not AF. Combined population attributable fraction of cardiovascular risk factors was >70% for incident MI, whereas it was only 27% for AF. Subsequent MI after AF (hazard ratio [HR], 1.68; 95% CI, 1.03-2.74) and subsequent AF after MI (HR, 1.75; 95% CI, 1.31-2.34) both significantly increased overall mortality risk.Conclusions: We observed different associations of cardiovascular risk factors with both diseases indicating distinct pathophysiological pathways. Subsequent diagnoses of MI and AF significantly increased mortality risk.
KW - mortality
KW - myocardial infarction
KW - risk factors
KW - cohort study
KW - atrial fibrillation
UR - http://www.scopus.com/inward/record.url?scp=85128245277&partnerID=8YFLogxK
U2 - 10.1161/JAHA.121.024299
DO - 10.1161/JAHA.121.024299
M3 - Article
C2 - 35322680
SN - 2047-9980
VL - 11
JO - Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease (JAHA)
JF - Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease (JAHA)
IS - 7
M1 - e024299
ER -
