In the last 2 decades, there has been a significant increase in the incidence, prevalence, and overall burden of atrial fibrillation (AF), with an estimated 33.5 million individuals affected worldwide in 2010 [Chugh SS et al. Circulation. 2014]. In a session at Heart Rhythm 2015, experts discussed the current understanding of the risk factors, predictors, and factors associated with AF.Although there are many known risk factors for AF, the identification of new risk factors and targets for therapies designed to prevent or delay AF remains important. Sumeet S. Chugh, MD, , reviewed some of the emerging predictors of AF.Elevated circulating troponin levels have been reported in ambulatory older adults with incident AF [Hussein AA et al. Heart Rhythm. 2015], while decreased levels of testosterone were associated with incident AF in men aged 55 to 69 years, especially those aged ≥ 80 years [Magnani JW et al. Circ Arrhythm Electrophysiol. 2014]. Inflammation as indicated by increased white blood cell count [Rienstra M et al. Am J Cardiol. 2012], elevated serum levels of uric acid [Chao TF et al. Int J Cardiol. 2013], and active inflammatory bowel disease [Kristensen SL et al. Europace. 2014] are significant risk indicators for the incidence AF in both men and women.The risk of AF is increased with obesity and extreme changes in weight. Among obese men (but not women), physical activity can attenuate this risk; that is, the risk for AF is increased 156%, 129%, and 37% among obese men with poor, intermediate, and ideal levels of activity, respectively [Huxley RR et al. Circ Arrhythm Electrophysiol. 2014]. Thyroid-stimulating hormone levels can indicate AF risk, with a low risk associated with overt hypothyroidism and a high risk with hyperthyroidism [Selmer C et al. BMJ. 2012]. The use of specific nonsteroidal anti-inflammatory drugs other than aspirin [Liu G et al. Am J Cardiol. 2014] and opioids [Qureshi W et al. Circulation. 2015] also were associated with an increased risk of incident AF.An analysis of 50 years of data from the Framingham Heart Study showed that the incidence and prevalence of AF appears to be increasing, which the investigators suggest may be partly due to enhanced surveillance [Schnabel RB et al. Lancet. 2015]. Lower rates of morbidity and mortality may be possible through the early detection of AF by increased awareness, targeted screening programs, and the recognition of new emerging risk factors.Stroke is the third-leading cause of death in women, who account for about 61% of all strokerelated deaths, according to Christine M. Albert, MD, Brigham and Women's Hospital, Boston, Massachusetts, USA, who discussed the risk factors for AF and stroke in women. The high burden of stroke among women is directly related to their longer life expectancy, their higher exposure to sex-specific risk factors (pregnancy, oral contraceptive use), and the fact that certain risk factors for stroke are stronger or more prevalent in women (migraine with aura, diabetes, AF).Among a group of healthy women, new-onset ...
