Genetic Predisposition to Lone Atrial Fibrillation and the Causal Effect on Cardiovascular Diseases: A Mendelian Randomization Study.
Background: Lone atrial fibrillation (AF) is characterized by the absence of discernible risk factors, yet its long-term prognostic implications remain unclear. We evaluated genetic predisposition to lone AF and conducted a Mendelian randomization (MR) study to assess its causal effect on cardiovascular outcomes. Methods: A genome-wide association study (GWAS) for lone AF, along with common AF was conducted using UK Biobank data. Lone AF was defined as AF occurring without clinical risk factors. Summary-level data for cardiovascular phenotypes were obtained from publicly available GWAS datasets and the causal effects were estimated using MR. Results: We identified 36 single-nucleotide polymorphisms associated with lone AF, including two novel loci. In MR analyses, lone AF was significantly associated with an increased risk of stroke (odds ratio [OR] 2.62, 95% confidence interval [CI] 2.14-3.22) and heart failure (HF) (OR 2.55, 95% CI 2.14-3.04). The associations with coronary artery disease (CAD) (OR 0.90, 95% CI 0.73-1.10) and cardiac death (OR 1.32, 95% CI 0.99-1.77) were not significant. MR analyses of common AF also demonstrated significant associations with stroke (OR 1.86, 95% CI 1.69-2.04) and HF (OR 1.71, 95% CI 1.59-1.84), though the effect sizes were smaller compared to those of lone AF. Conclusions: Genetic predisposition to lone AF is associated with more than a twofold increase in the risk of stroke and HF. However, no clear association was observed between lone AF and CAD or cardiac death.
Authors
Park Park, Kim Kim, Seo Seo, Kim Kim, Hwang Hwang, Kim Kim, Lee Lee, Chung Chung, Choi Choi
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