title: Relation Between Estimated Cardiorespiratory Fitness and Atrial Fibrillation (from the Reasons for Geographic and Racial Differences in Stroke Study).
abstract: Estimated cardiorespiratory fitness (e-CRF) based on readily available clinical and self-reported data is a promising alternative to the costly traditional assessment of CRF using exercise equipment, but its role as a predictor for incident atrial fibrillation (AF) is unclear. This study included 10,126 participants (54.5% women, 35% African-American, mean age 63.2 years) from the Reasons for Geographic and Racial Differences in Stroke study who were free of AF at baseline. Baseline (2003 to 2007) e-CRF was determined using a previously validated nonexercise algorithm. Incident AF cases were identified at a follow-up examination by electrocardiogram and self-reported medical history of previous physician diagnosis. After a median follow-up of 9.4 years, 906 participants (8.9%) developed AF. In a multivariable logistic regression model adjusted for sociodemographics and baseline cardiovascular disease risk factors as well as incident coronary heart disease, heart failure, and stroke, each 1-metabolic equivalent of task increase in e-CRF was associated with a 5% lower risk of AF development (odds ratio [95% CI] 0.95 [0.92 to 0.99]; p = 0.0129). This association was stronger in women (OR [95% CI] 0.85 (0.79, 0.92) than in men (OR (95% CI) 0.88 (0.84, 0.93), interaction p value = 0.05. No significant interactions by age, race, history of cardiovascular disease, or physical limitations were observed. In conclusion, e-CRF using a nonexercise algorithm is a useful predictor of incident AF, which is consistent with previous reports using traditional CRF. This suggests that e-CRF using nonexercise algorithms may serve as a useful alternative to CRF measured by costly and time-consuming exercise testing.
authors.affiliation: Section of Hospital Medicine, Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Bose
authors.affiliation: Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Wesley T
authors.initials: WT
authors.lastname: O'Neal
authors.affiliation: Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Aleena
authors.initials: A
authors.lastname: Bennett
authors.affiliation: Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Judd
authors.affiliation: Section of Cardiology, Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Waqas T
authors.initials: WT
authors.lastname: Qureshi
authors.affiliation: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
authors.forename: Xuemei
authors.initials: X
authors.lastname: Sui
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Virginia J
authors.initials: VJ
authors.lastname: Howard
authors.affiliation: Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: George
authors.initials: G
authors.lastname: Howard
authors.affiliation: Section of Cardiology, Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina; Department of Epidemiology and Prevention, Epidemiological Cardiology Research Center, Wake Forest School of Medicine, Winston-Salem, North Carolina. Electronic address: esoliman@wakehelath.edu.
authors.forename: Elsayed Z
authors.initials: EZ
authors.lastname: Soliman
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis* / Q000208:ethnology; D000072599:Cardiorespiratory Fitness; D004562:Electrocardiography; D005080:Exercise Test / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D057566:Self Report; D020521:Stroke / Q000208:ethnology* / Q000209:etiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014481:United States / Q000453:epidemiology