Elsevier

American Heart Journal

Volume 162, Issue 3, September 2011, Pages 538-541
American Heart Journal

Clinical Investigation
Electrophysiology
Vitamin D status is not related to development of atrial fibrillation in the community

https://doi.org/10.1016/j.ahj.2011.06.013Get rights and content

Background

Atrial fibrillation (AF) is common and is an important cause of cardiovascular morbidity and mortality. Vitamin D is an emerging risk factor in cardiovascular disease, and vitamin D status is modifiable. Thus, we sought to investigate whether vitamin D status predisposed to the development of AF in a community-based sample.

Methods

We evaluated the relation between vitamin D status and development of AF in 2,930 participants of the Framingham Heart Study, Massachusetts, USA, without prevalent AF. The mean age was 65 ± 11 years, and 56% were women. Vitamin D status was assessed by measuring 25-hydroxyvitamin D (25[OH]D) concentrations. Multivariable Cox regression models were adjusted for AF risk factors and season.

Results

During a mean follow-up of 9.9 years, 425 participants (15%) developed AF. In Cox proportional hazards models, 25(OH)D was not associated with development of AF, with a multivariable-adjusted hazard ratio of 0.99 per SD increment in 25(OH)D levels (95% CI 0.88-1.10, P = .81). Also, no relation was found in models including 25(OH)D as a dichotomous variable (above and below the cohort-specific 20th percentile; P = .59).

Conclusion

In our community-based sample, vitamin D status was not related to incident AF. Our data suggest that vitamin D deficiency does not promote the development of AF in the ambulatory setting.

Section snippets

Study sample

The study sample was derived from the Original and Offspring cohorts of the Framingham Heart Study. The Original cohort was established in 1948 and included 5,209 residents of Framingham, Massachusetts, USA.22 Between 1988 and 1989, 1,130 participants attended the 20th biennial examination and had measurement of 25(OH)D levels. Since 25-hydroxyvitamin D (25[OH]D) is the precursor of the biologically active form of vitamin D (1,25[OH]D) and integrates endogenous synthesis with intake from diet

Characteristics

In total, 2,930 participants without prevalent AF, 1,046 from the Original cohort and 1,884 from the Offspring cohort, were included in the analysis. The characteristics of the study sample are shown in Table I. In the Original cohort, the mean age of participants was 76 ± 6 years, and 63% were women. In the Offspring cohort, the mean age of participants was 60 ± 9 years, and 53% were women.

Multivariable analyses

During a mean follow-up of 9.9 ± 4.0 years, 425 participants (15%) developed AF. The results of the

Discussion

In summary, we found no association between vitamin D status and the development of AF in a large, community-based cohort. The validity of our results is supported by the large sample size, the routine ascertainment of both vitamin D status and AF events, the consistency of our findings in the diverse multivariable models, and the analyses adequately powered to detect a moderate effect size. To our knowledge, this is the first study to examine the relation of vitamin D deficiency with the

Disclosures

Dr. Wang has participated on the scientific advisory board of Diasorin, Inc. He is an investigator on a study sponsored by Diasorin, Inc.

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    Sources of funding: This work was supported by grants from the National Institutes of Health (NO1-HC-25195, K23-HL-074077, R01-AG14759, K23-RR-017376-04, and K24-HL-04334; 1R01HL092577; 1RC1HL101056; 1R01HL102214; 6R01-NS 17950; 1R01HL092577; R01AG028321; 5R21DA027021; 5RO1HL104156; 1K24HL105780), the US Department of Agriculture (agreement 58-1950-4-401), and the American Heart Association. Dr Rienstra is supported by a grant from the Netherlands Organization for Scientific Research (Rubicon Grant 825.09.020). Dr Cheng is supported by a grant from the Ellison Foundation. Dr Magnani is supported by American Heart Association Award 09FTF2190028. This work was partially supported by the Evans Center for Interdisciplinary Biomedical Research ARC on Atrial Fibrillation Initiative at Boston University.

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