Clinical and Genetic Risk Factors Predict Atrial Fibrillation on the Basis of Hypertrophic Cardiomyopathy

Background Clinical and genetic predispositions are significant in predicting atrial fibrillation (AF); however, their role in patients with hypertrophic cardiomyopathy (HCM) remains unclear. This study aims to elucidate the impact of clinical and genetic risk factors on the development of AF in pat...

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Main Authors: Young Shin Lee, Pil‐Sung Yang, Eunsun Jang, Daehoon Kim, Hee Tae Yu, Tae‐Hoon Kim, Jae‐Sun Uhm, Jung‐Hoon Sung, Hui‐Nam Pak, Moon‐Hyoung Lee, Jin‐Bae Kim, Boyoung Joung
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.038074
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author Young Shin Lee
Pil‐Sung Yang
Eunsun Jang
Daehoon Kim
Hee Tae Yu
Tae‐Hoon Kim
Jae‐Sun Uhm
Jung‐Hoon Sung
Hui‐Nam Pak
Moon‐Hyoung Lee
Jin‐Bae Kim
Boyoung Joung
author_facet Young Shin Lee
Pil‐Sung Yang
Eunsun Jang
Daehoon Kim
Hee Tae Yu
Tae‐Hoon Kim
Jae‐Sun Uhm
Jung‐Hoon Sung
Hui‐Nam Pak
Moon‐Hyoung Lee
Jin‐Bae Kim
Boyoung Joung
author_sort Young Shin Lee
collection DOAJ
description Background Clinical and genetic predispositions are significant in predicting atrial fibrillation (AF); however, their role in patients with hypertrophic cardiomyopathy (HCM) remains unclear. This study aims to elucidate the impact of clinical and genetic risk factors on the development of AF in patients with and without HCM. Methods and Results This retrospective analysis involved data from the UK Biobank cohort. Participants were divided into 3 groups based on their validated polygenic risk score for AF: the bottom 10% as low risk, the top 10% as high risk, and the rest as intermediate risk. We assessed the incidence of AF and cardiovascular complications and analyzed its predictors, including genetic risk. We examined 1180 patients with HCM (mean age, 61.1±7.1; 63.0% men) and 476 238 participants without HCM (mean age, 57.0±8.1; 45.3% men). During the 11.6‐year follow‐up period, the age‐ and sex‐adjusted AF incidence rates for the low, intermediate, and high genetic risk groups were 2.4, 3.6, and 5.4 per 100 person‐years in participants with HCM and 0.2, 0.5, and 1.0 per 100 person‐years in participants without HCM, respectively. Genetic risk, evaluated as a continuous variable using polygenic risk score, was a less significant predictor of AF in the HCM group (hazard ratio [HR], 1.35 [95% CI, 1.21–1.49]) than in non‐HCM group (HR, 1.57 [95% CI, 1.56–1.59]; P=0.005 for interaction). A high genetic risk was significantly associated with the risk of cardiovascular complications in both groups. Conclusions Genetic predisposition is associated with the development of AF and cardiovascular complications in people with and without HCM; this association was weaker in the HCM group.
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spelling doaj-art-34d588ad33df41c596c60e3129ee9a6b2025-08-20T03:07:46ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-03-0114610.1161/JAHA.124.038074Clinical and Genetic Risk Factors Predict Atrial Fibrillation on the Basis of Hypertrophic CardiomyopathyYoung Shin Lee0Pil‐Sung Yang1Eunsun Jang2Daehoon Kim3Hee Tae Yu4Tae‐Hoon Kim5Jae‐Sun Uhm6Jung‐Hoon Sung7Hui‐Nam Pak8Moon‐Hyoung Lee9Jin‐Bae Kim10Boyoung Joung11Division of Cardiology Department of Internal Medicine Kyung Hee University Medical Center Seoul KoreaDepartment of Cardiology CHA Bundang Medical Center CHA University Seongnam Republic of KoreaDivision of Cardiology Department of Internal Medicine Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of KoreaDepartment of Cardiology CHA Bundang Medical Center CHA University Seongnam Republic of KoreaDivision of Cardiology Department of Internal Medicine Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Kyung Hee University Medical Center Seoul KoreaDivision of Cardiology Department of Internal Medicine Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of KoreaBackground Clinical and genetic predispositions are significant in predicting atrial fibrillation (AF); however, their role in patients with hypertrophic cardiomyopathy (HCM) remains unclear. This study aims to elucidate the impact of clinical and genetic risk factors on the development of AF in patients with and without HCM. Methods and Results This retrospective analysis involved data from the UK Biobank cohort. Participants were divided into 3 groups based on their validated polygenic risk score for AF: the bottom 10% as low risk, the top 10% as high risk, and the rest as intermediate risk. We assessed the incidence of AF and cardiovascular complications and analyzed its predictors, including genetic risk. We examined 1180 patients with HCM (mean age, 61.1±7.1; 63.0% men) and 476 238 participants without HCM (mean age, 57.0±8.1; 45.3% men). During the 11.6‐year follow‐up period, the age‐ and sex‐adjusted AF incidence rates for the low, intermediate, and high genetic risk groups were 2.4, 3.6, and 5.4 per 100 person‐years in participants with HCM and 0.2, 0.5, and 1.0 per 100 person‐years in participants without HCM, respectively. Genetic risk, evaluated as a continuous variable using polygenic risk score, was a less significant predictor of AF in the HCM group (hazard ratio [HR], 1.35 [95% CI, 1.21–1.49]) than in non‐HCM group (HR, 1.57 [95% CI, 1.56–1.59]; P=0.005 for interaction). A high genetic risk was significantly associated with the risk of cardiovascular complications in both groups. Conclusions Genetic predisposition is associated with the development of AF and cardiovascular complications in people with and without HCM; this association was weaker in the HCM group.https://www.ahajournals.org/doi/10.1161/JAHA.124.038074atrial fibrillationhypertrophic cardiomyopathypolygenic risk scoreUK Biobank
spellingShingle Young Shin Lee
Pil‐Sung Yang
Eunsun Jang
Daehoon Kim
Hee Tae Yu
Tae‐Hoon Kim
Jae‐Sun Uhm
Jung‐Hoon Sung
Hui‐Nam Pak
Moon‐Hyoung Lee
Jin‐Bae Kim
Boyoung Joung
Clinical and Genetic Risk Factors Predict Atrial Fibrillation on the Basis of Hypertrophic Cardiomyopathy
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
atrial fibrillation
hypertrophic cardiomyopathy
polygenic risk score
UK Biobank
title Clinical and Genetic Risk Factors Predict Atrial Fibrillation on the Basis of Hypertrophic Cardiomyopathy
title_full Clinical and Genetic Risk Factors Predict Atrial Fibrillation on the Basis of Hypertrophic Cardiomyopathy
title_fullStr Clinical and Genetic Risk Factors Predict Atrial Fibrillation on the Basis of Hypertrophic Cardiomyopathy
title_full_unstemmed Clinical and Genetic Risk Factors Predict Atrial Fibrillation on the Basis of Hypertrophic Cardiomyopathy
title_short Clinical and Genetic Risk Factors Predict Atrial Fibrillation on the Basis of Hypertrophic Cardiomyopathy
title_sort clinical and genetic risk factors predict atrial fibrillation on the basis of hypertrophic cardiomyopathy
topic atrial fibrillation
hypertrophic cardiomyopathy
polygenic risk score
UK Biobank
url https://www.ahajournals.org/doi/10.1161/JAHA.124.038074
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