The association of education and household income with the lifetime risk of incident atrial fibrillation: The Framingham Heart study

Ataklte, Feven; Huang, Quixi; Kornej, Jelena; Mondesir, Favel L.; Benjamin, Emelia J.; Trinquart, Ludovic

doi:10.1016/j.ajpc.2022.100314

Cited by 8 publications

(3 citation statements)

References 27 publications

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“…We found no evidence of association with incident AF, and it suggests less inequality with similar absolute risks between patients at lower and higher socioeconomic positions. This finding is consistent with results from the Framingham Heart Study, which found no evidence of the association between education or household income and lifetime risk of AF 22 . A possible explanation is that regular follow‐up of patients with HF is necessary to evaluate the clinical status including heart rhythm and ensure optimal care.…”

Section: Discussionsupporting

confidence: 86%

“…This finding is consistent with results from the Framingham Heart Study, which found no evidence of the association between education or household income and lifetime risk of AF. 22 A possible explanation is that regular follow‐up of patients with HF is necessary to evaluate the clinical status including heart rhythm and ensure optimal care. The most recent European guidelines for HF recommend intervals of clinical follow‐up of no more than 6 months, and the follow‐ups should be more frequent among patients recently discharged.…”

Section: Discussionmentioning

confidence: 99%

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Social determinants of health and cardiovascular outcomes in patients with heart failure

Vinter

Fawzy

Gent

et al. 2022

Eur J Clin Investigation

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Background We examined the associations between family income and educational attainment with incident atrial fibrillation (AF), myocardial infarction (MI), stroke and cardiovascular (CV) death among patients with newly‐diagnosed heart failure (HF). Methods In a nationwide Danish registry of HF patients diagnosed between 2008 and 2018, we established a cohort for each outcome. When examining AF, MI and stroke, respectively, patients with a history of these outcomes at diagnosis of HF were excluded. We used cause‐specific proportional hazard models to estimate hazard ratios for tertile groups of family income and three levels of educational attainment. Results Among 27,947 AF‐free patients, we found no association between income or education and incident AF. Among 27,309 MI‐free patients, we found that lower income (hazard ratio 1.28 [95% CI 1.11–1.48] and 1.11 [0.96–1.28] for lower and medium vs. higher income) and education (1.23 [1.04–1.45] and 1.15 [0.97–1.36] for lower and medium vs. higher education) were associated with MI. Among 36,801 stroke‐free patients, lower income was associated with stroke (1.38 [1.23–1.56] and 1.27 [1.12–1.44] for lower and medium vs. higher income) but not education. Lower income (1.56 [1.46–1.67] and 1.32 [1.23–1.42] for lower and medium vs. higher income) and education (1.20 [1.11–1.29] and 1.07 [0.99–1.15] for lower and medium vs. higher education) were associated with CV death. Conclusions In patients with newly‐diagnosed HF, lower family income was associated with higher rates of acute MI, stroke and cardiovascular death. Lower educational attainment was associated with higher rates of acute MI and cardiovascular death. There was no evidence of associations between income and education with incident AF.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Social determinants of health and cardiovascular outcomes in patients with heart failure

Vinter

Fawzy

Gent

et al. 2022

Eur J Clin Investigation

Self Cite

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“…Atrial fibrillation (AF) is the commonest clinically significant cardiac arrhythmia with a lifetime risk of approximately 1:3 [ 1 , 2 ]. The incidence is also predicted to double in the next 40 years due to aging of the population and increasing incidence of metabolic syndrome [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Development of a robust induced pluripotent stem cell atrial cardiomyocyte differentiation protocol to model atrial arrhythmia

et al. 2023

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Background Atrial fibrillation is the most common arrhythmia syndrome and causes significant morbidity and mortality. Current therapeutics, however, have limited efficacy. Notably, many therapeutics shown to be efficacious in animal models have not proved effective in humans. Thus, there is a need for a drug screening platform based on human tissue. The aim of this study was to develop a robust protocol for generating atrial cardiomyocytes from human-induced pluripotent stem cells. Methods A novel protocol for atrial differentiation, with optimized timing of retinoic acid during mesoderm formation, was compared to two previously published methods. Each differentiation method was assessed for successful formation of a contractile syncytium, electrical properties assayed by optical action potential recordings and multi-electrode array electrophysiology, and response to the G-protein-gated potassium channel activator, carbamylcholine. Atrial myocyte monolayers, derived using the new differentiation protocol, were further assessed for cardiomyocyte purity, gene expression, and the ability to form arrhythmic rotors in response to burst pacing. Results Application of retinoic acid at day 1 of mesoderm formation resulted in a robust differentiation of atrial myocytes with contractile syncytium forming in 16/18 differentiations across two cell lines. Atrial-like myocytes produced have shortened action potentials and field potentials, when compared to standard application of retinoic acid at the cardiac mesoderm stage. Day 1 retinoic acid produced atrial cardiomyocytes are also carbamylcholine sensitive, indicative of active Ikach currents, which was distinct from ventricular myocytes and standard retinoic addition in matched differentiations. A current protocol utilizing reduced Activin A and BMP4 can produce atrial cardiomyocytes with equivalent functionality but with reduced robustness of differentiation; only 8/17 differentiations produced a contractile syncytium. The day 1 retinoic acid protocol was successfully applied to 6 iPSC lines (3 male and 3 female) without additional optimization or modification. Atrial myocytes produced could also generate syncytia with rapid conduction velocities, > 40 cm s−1, and form rotor style arrhythmia in response to burst pacing. Conclusions This method combines an enhanced atrial-like phenotype with robustness of differentiation, which will facilitate further research in human atrial arrhythmia and myopathies, while being economically viable for larger anti-arrhythmic drug screens.

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Mechanisms and Clinical Manifestations of Cognitive Decline in Atrial Fibrillation Patients: Potential Implications for Preventing Dementia

Blum¹,

Conen²

2023

Canadian Journal of Cardiology

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The association of education and household income with the lifetime risk of incident atrial fibrillation: The Framingham Heart study

Cited by 8 publications

References 27 publications

Social determinants of health and cardiovascular outcomes in patients with heart failure

Social determinants of health and cardiovascular outcomes in patients with heart failure

Development of a robust induced pluripotent stem cell atrial cardiomyocyte differentiation protocol to model atrial arrhythmia

Mechanisms and Clinical Manifestations of Cognitive Decline in Atrial Fibrillation Patients: Potential Implications for Preventing Dementia

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