title: Airflow obstruction, lung function, and incidence of atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) study.
abstract: BACKGROUND
  Reduced low forced expiratory volume in 1 second (FEV1) is reportedly associated with an increased risk of atrial fibrillation (AF). Extant reports do not provide separate estimates for never smokers or for blacks, who incongruously have lower AF incidence than whites.
  
  
  RESULTS
  We examined 15 004 middle-aged blacks and whites enrolled in the Atherosclerosis Risk in Communities (ARIC) cohort study. Standardized spirometry data were collected at the baseline examination. Incident AF was identified from the first among the following: International Classification of Diseases codes for AF on hospital discharge records or death certificates or 12-lead ECGs performed during 3 triennial follow-up visits. Over an average follow-up of 17.5 years, a total of 1691 participants (11%) developed new-onset AF. The rate of incident AF was inversely associated with FEV1 in each of the 4 race and sex groups. After multivariable adjustment for traditional cardiovascular disease risk factors and height, hazard ratios of AF comparing the lowest with the highest quartile of FEV1 were 1.37 (95% confidence interval, 1.02-1.83) for white women, 1.49 (95% confidence interval, 1.16-1.91) for white men, 1.63 (95% confidence interval, 1.00-2.66) for black women, and 2.36 (95% confidence interval, 1.30-4.29) for black men. The above associations were observed across all smoking status categories. Moderate/severe airflow obstruction (FEV1/forced vital capacity <0.70 and FEV1 < 80% of predicted value) was also associated with higher AF incidence.
  
  
  CONCLUSIONS
  In this large population-based study with a long-term follow-up, reduced FEV1 and obstructive respiratory disease were associated with a higher AF incidence after adjustment for measured confounders.
authors.affiliation: University of North Carolina, Chapel Hill, NC (J.L., L.R.L., A.M.M., C.P., G.H.); Johns Hopkins University, Baltimore, MD (S.K.A.); University of Minnesota, Minneapolis (A.A.); New York University Medical Center, New York (S.B.); Mayo Clinic, Rochester, MN (A.M.C.); National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC (S.J.L.); and Wake Forest University, Winston Salem, NC (E.Z.S.).
authors.forename: Jingjing
authors.initials: J
authors.lastname: Li
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Agarwal
authors.forename: Alvaro
authors.initials: A
authors.lastname: Alonso
authors.forename: Saul
authors.initials: S
authors.lastname: Blecker
authors.forename: Alanna M
authors.initials: AM
authors.lastname: Chamberlain
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: London
authors.forename: Laura R
authors.initials: LR
authors.lastname: Loehr
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: McNeill
authors.forename: Charles
authors.initials: C
authors.lastname: Poole
authors.forename: Elsayed Z
authors.initials: EZ
authors.lastname: Soliman
authors.forename: Gerardo
authors.initials: G
authors.lastname: Heiss
mesh_terms: D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000208:ethnology*; D044383:Black People / Q000208:ethnology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology*; D008173:Lung Diseases, Obstructive / Q000208:ethnology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012129:Respiratory Function Tests; D012307:Risk Factors; D013147:Spirometry; D044465:White People / Q000208:ethnology
keywords: atrial fibrillation; forced expiratory volume; pulmonary disease, chronic obstructive; respiratory physiological phenomena; risk factors; vital capacity