title: Association of Sleep Apnea and Snoring With Incident Atrial Fibrillation in the Multi-Ethnic Study of Atherosclerosis.
abstract: The association between sleep apnea and atrial fibrillation (AF) has not been examined in a multiethnic adult population in prospective community-based studies. We prospectively (2000-2011) investigated the associations of physician-diagnosed sleep apnea (PDSA), which is considered more severe sleep apnea, and self-reported habitual snoring without PDSA (HS), a surrogate for mild sleep apnea, with incident AF in white, black, and Hispanic participants in the Multi-Ethnic Study of Atherosclerosis (MESA) who were free of clinical cardiovascular disease at baseline (2000-2002). Cox proportional hazards models were used to assess the associations, with adjustment for socioeconomic status, traditional vascular disease risk factors, race/ethnicity, body mass index, diabetes, chronic kidney disease, alcohol intake, and lipid-lowering therapy. Out of 4,395 respondents to a sleep questionnaire administered in MESA, 181 reported PDSA, 1,086 reported HS, and 3,128 reported neither HS nor PDSA (unaffected). Over an average 8.5-year follow-up period, 212 AF events were identified. As compared with unaffected participants, PDSA was associated with incident AF in the multivariable analysis, but HS was not (PDSA: hazard ratio = 1.76, 95% confidence interval: 1.03, 3.02; HS: hazard ratio = 1.02, 95% confidence interval: 0.72, 1.44). PDSA, a marker of more severe sleep apnea, was associated with higher risk of incident AF in this analysis of MESA data.
authors.forename: Gen-Min
authors.initials: GM
authors.lastname: Lin
authors.forename: Laura A
authors.initials: LA
authors.lastname: Colangelo
authors.forename: Donald M
authors.initials: DM
authors.lastname: Lloyd-Jones
authors.forename: Susan
authors.initials: S
authors.lastname: Redline
authors.forename: Joseph
authors.initials: J
authors.lastname: Yeboah
authors.forename: Susan R
authors.initials: SR
authors.lastname: Heckbert
authors.forename: Saman
authors.initials: S
authors.lastname: Nazarian
authors.forename: Alvaro
authors.initials: A
authors.lastname: Alonso
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.forename: Naresh M
authors.initials: NM
authors.lastname: Punjabi
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis; D001281:Atrial Fibrillation / Q000453:epidemiology*; D015992:Body Mass Index; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D015994:Incidence; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D012891:Sleep Apnea Syndromes / Q000453:epidemiology*; D012913:Snoring / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
chemical_list: D015850:Interleukin-6
keywords: atrial fibrillation; longitudinal studies; sleep apnea; snoring