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Obstructive sleep apnea, obesity, and the risk of incident atrial fibrillation.
J Am Coll Cardiol. 2007 Feb 06; 49(5):565-71.JACC

Abstract

OBJECTIVES

This study sought to identify whether obesity and obstructive sleep apnea (OSA) independently predict incident atrial fibrillation/flutter (AF).

BACKGROUND

Obesity is a risk factor for AF, and OSA is highly prevalent in obesity. Obstructive sleep apnea is associated with AF, but it is unknown whether OSA predicts new-onset AF independently of obesity.

METHODS

We conducted a retrospective cohort study of 3,542 Olmsted County adults without past or current AF who were referred for an initial diagnostic polysomnogram from 1987 to 2003. New-onset AF was assessed and confirmed by electrocardiography during a mean follow-up of 4.7 years.

RESULTS

Incident AF occurred in 133 subjects (cumulative probability 14%, 95% confidence interval [CI] 9% to 19%). Univariate predictors of AF were age, male gender, hypertension, coronary artery disease, heart failure, smoking, body mass index, OSA (hazard ratio 2.18, 95% CI 1.34 to 3.54) and multiple measures of OSA severity. In subjects <65 years old, independent predictors of incident AF were age, male gender, coronary artery disease, body mass index (per 1 kg/m2, hazard ratio 1.07, 95% CI 1.05 to 1.10), and the decrease in nocturnal oxygen saturation (per 0.5 U log change, hazard ratio 3.29, 95% CI 1.35 to 8.04). Heart failure, but neither obesity nor OSA, predicted incident AF in subjects > or =65 years of age.

CONCLUSIONS

Obesity and the magnitude of nocturnal oxygen desaturation, which is an important pathophysiological consequence of OSA, are independent risk factors for incident AF in individuals <65 years of age.

Authors+Show Affiliations

Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17276180

Citation

Gami, Apoor S., et al. "Obstructive Sleep Apnea, Obesity, and the Risk of Incident Atrial Fibrillation." Journal of the American College of Cardiology, vol. 49, no. 5, 2007, pp. 565-71.
Gami AS, Hodge DO, Herges RM, et al. Obstructive sleep apnea, obesity, and the risk of incident atrial fibrillation. J Am Coll Cardiol. 2007;49(5):565-71.
Gami, A. S., Hodge, D. O., Herges, R. M., Olson, E. J., Nykodym, J., Kara, T., & Somers, V. K. (2007). Obstructive sleep apnea, obesity, and the risk of incident atrial fibrillation. Journal of the American College of Cardiology, 49(5), 565-71.
Gami AS, et al. Obstructive Sleep Apnea, Obesity, and the Risk of Incident Atrial Fibrillation. J Am Coll Cardiol. 2007 Feb 6;49(5):565-71. PubMed PMID: 17276180.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Obstructive sleep apnea, obesity, and the risk of incident atrial fibrillation. AU - Gami,Apoor S, AU - Hodge,Dave O, AU - Herges,Regina M, AU - Olson,Eric J, AU - Nykodym,Jiri, AU - Kara,Tomas, AU - Somers,Virend K, Y1 - 2007/01/22/ PY - 2006/03/30/received PY - 2006/08/22/revised PY - 2006/08/28/accepted PY - 2007/2/6/pubmed PY - 2007/4/4/medline PY - 2007/2/6/entrez SP - 565 EP - 71 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 49 IS - 5 N2 - OBJECTIVES: This study sought to identify whether obesity and obstructive sleep apnea (OSA) independently predict incident atrial fibrillation/flutter (AF). BACKGROUND: Obesity is a risk factor for AF, and OSA is highly prevalent in obesity. Obstructive sleep apnea is associated with AF, but it is unknown whether OSA predicts new-onset AF independently of obesity. METHODS: We conducted a retrospective cohort study of 3,542 Olmsted County adults without past or current AF who were referred for an initial diagnostic polysomnogram from 1987 to 2003. New-onset AF was assessed and confirmed by electrocardiography during a mean follow-up of 4.7 years. RESULTS: Incident AF occurred in 133 subjects (cumulative probability 14%, 95% confidence interval [CI] 9% to 19%). Univariate predictors of AF were age, male gender, hypertension, coronary artery disease, heart failure, smoking, body mass index, OSA (hazard ratio 2.18, 95% CI 1.34 to 3.54) and multiple measures of OSA severity. In subjects <65 years old, independent predictors of incident AF were age, male gender, coronary artery disease, body mass index (per 1 kg/m2, hazard ratio 1.07, 95% CI 1.05 to 1.10), and the decrease in nocturnal oxygen saturation (per 0.5 U log change, hazard ratio 3.29, 95% CI 1.35 to 8.04). Heart failure, but neither obesity nor OSA, predicted incident AF in subjects > or =65 years of age. CONCLUSIONS: Obesity and the magnitude of nocturnal oxygen desaturation, which is an important pathophysiological consequence of OSA, are independent risk factors for incident AF in individuals <65 years of age. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/17276180/Obstructive_sleep_apnea_obesity_and_the_risk_of_incident_atrial_fibrillation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(06)02859-2 DB - PRIME DP - Unbound Medicine ER -