title: A multimarker approach to assess the influence of inflammation on the incidence of atrial fibrillation in women.
abstract: OBJECTIVE
  To assess the joint influence of inflammatory biomarkers on the risk of incident atrial fibrillation (AF) in women.
  
  
  RESULTS
  We performed a prospective cohort study among women participating in the Women's Health Study. All women were free of AF at study entry and provided a baseline blood sample assayed for high-sensitivity C-reactive protein, soluble intercellular adhesion molecule-1, and fibrinogen. To evaluate the joint effect of these three biomarkers, an inflammation score was created that ranged from 0 to 3 and reflected the number of biomarkers in the highest tertile per individual. During a median follow-up of 14.4 years, 747 of 24,734 women (3.0%) experienced a first AF event. Assessed individually, all three biomarkers were associated with incident AF, even after adjustment for traditional risk factors. When combined into an inflammation score, a strong and independent relationship between inflammation and incident AF emerged. Across increasing inflammation score categories, there were 1.66, 2.22, 2.73, and 3.25 AF events per 1000 person-years of follow-up. The corresponding hazard ratios (95% confidence intervals) across inflammation score categories were 1.0, 1.22 (1.00-1.49), 1.32 (1.06-1.65), and 1.59 (1.22-2.06) (P for linear trend 0.0006) after multivariable adjustment.
  
  
  CONCLUSIONS
  In this large-scale prospective study among women without a history of cardiovascular disease, markers of systemic inflammation were significantly related to AF even after controlling for traditional risk factors.
authors.affiliation: Center for Arrhythmia Prevention Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. conend@uhbs.ch
authors.forename: David
authors.initials: D
authors.lastname: Conen
authors.forename: Paul M
authors.initials: PM
authors.lastname: Ridker
authors.forename: Brendan M
authors.initials: BM
authors.lastname: Everett
authors.forename: Usha B
authors.initials: UB
authors.lastname: Tedrow
authors.forename: Lynda
authors.initials: L
authors.lastname: Rose
authors.forename: Nancy R
authors.initials: NR
authors.lastname: Cook
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
authors.forename: Christine M
authors.initials: CM
authors.lastname: Albert
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology*; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism*; D008875:Middle Aged; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D018799:Intercellular Adhesion Molecule-1; D005340:Fibrinogen; D002097:C-Reactive Protein