scholarly journals Association between Cardiovascular Health and Incident Atrial Fibrillation in the General Japanese Population Aged ≥40 Years

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3201
Author(s):  
Tetsuo Nishikawa ◽  
Yoshihiro Tanaka ◽  
Hayato Tada ◽  
Toyonobu Tsuda ◽  
Takeshi Kato ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Confidence Interval ◽  
Japanese Population ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Smoking Status ◽  
Lifestyle Behavior ◽  
General Japanese Population ◽  
Japanese Residents ◽  
The Individual

This study explores the association between lifestyle behavior and incident atrial fibrillation (AF) in the general Japanese population. Japanese residents aged ≥40 years undergoing a national health checkup in Kanazawa City were included. We hypothesized that better lifestyle behavior is associated with lower incidence of AF. Lifestyle behavior was evaluated by the total cardiovascular health (CVH) score (0 = poor to 14 = ideal), calculated as the sum of the individual scores on seven modifiable risk factors: smoking status, physical activity, obesity, patterns of eating schedule, blood pressure, total cholesterol, and blood glucose. The association between CVH and incident AF was assessed, adjusting for other factors. A total of 37,523 participants (mean age 72.3 ± 9.6 years, 36.8% men, and mean total CVH score 9 ± 1) were analyzed. During the median follow-up period of 5 years, 703 cases of incident AF were observed. Using a low CVH score as a reference, the upper group (ideal CVH group) had a significantly lower risk of incident AF (hazard ratio [HR] = 0.79, 95% confidence interval 0.65–0.96, p = 0.02), especially among those aged <75 years (HR = 0.68, 95% confidence interval 0.49–0.94, p = 0.02). Thus, ideal CVH is independently associated with a lower risk for incident AF, particularly in younger Japanese individuals (<75 years).

Abstract MP03: Plasma Sphingolipids and Risks of Heart Failure and Atrial Fibrillation in Older Adults: The Cardiovascular Health Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Rozenn N Lemaitre ◽  
Paul N Jensen ◽  
Barbara McKnight ◽  
Andrew Hoofnagle ◽  
Irena B King ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Fatty Acid ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Biological Activities ◽  
Experimental Studies ◽  
Health Study ◽  
Cardiovascular Health Study

Introduction: Ceramides and sphingomyelins (sphingolipids) are circulating lipids involved in multiple physiological pathways relevant to heart failure (HF) and atrial fibrillation (AF), including apoptosis, oxidative stress, and inflammation. Experimental studies suggest that sphingolipids with different saturated fatty acids exhibit different biological activities, but their relationships with HF and AF are unknown. Hypothesis: Higher levels of plasma ceramide and sphingomyelin that contain the fatty acid 16:0 are associated with higher risks of HF and AF; and higher levels of ceramides and sphingomyelins that contain the fatty acid 20:0, 22:0 or 24:0 are associated with lower risks. Methods: We measured sphingolipids in the Cardiovascular Health Study (CHS) in plasma samples from 1994-95 (N=4026) or from 1992-93 (N=586). We assessed the separate associations of the levels of 8 sphingolipids with risks of incident HF and incident AF using Cox regression. A p-value threshold of 0.006 was used to account for multiple testing. Results: Among 4,612 participants, 1179 incident HF and 1198 incident AF occurred during >40,000 person-years of follow-up. In adjusted analyses, higher levels of Cer-16 (ceramide with 16:0) and SM-16 (sphingomyelin with 16:0) were associated with higher risk of incident HF, but not with risk of incident AF (Table). In contrast, higher levels of Cer-20, Cer-22 and Cer-24 were each associated with lower risk of AF, but not with risk of HF. Higher levels of SM-20, SM-22, and SM-24 tended to be associated with lower risks of AF and HF, with only the association of SM-20 with AF significant. Conclusions: Plasma levels of ceramide and sphingomyelin with 16:0 show different associations with HF and AF than species with 20:0, 22:0 or 24:0. Associations of Cer-16 and SM-16 specifically with higher risk of HF may be due to a role of apoptosis in HF. The novel findings that Cer-20, Cer-22, and Cer-24 are associated with lower risk of AF warrant further examination of the role of these sphingolipids in protecting from AF.

Direct Oral Anticoagulants in Patients with Cancer

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 877-877 ◽  
Author(s):  
Surbhi Shah ◽  
Yvonne H Datta ◽  
Faye Norby ◽  
Alvaro Alonso
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Confidence Interval ◽  
Cancer Patients ◽  
Lower Risk ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Morbidity And Mortality ◽  
Severe Bleeding ◽  
Diagnostic Codes

Abstract Introduction Cancer patients are at high risk for morbidity and mortality due to thrombosis and bleeding, in addition they may also have pre-existing conditions, such as atrial fibrillation (AF) and prior venous thromboembolism (VTE), for which chronic anticoagulation may be indicated. Historically, warfarin was the most commonly prescribed anticoagulant for stroke prevention in AF patients. Since 2010, the US FDA has approved 4 alternative direct oral anticoagulants (DOACs) - dabigatran, rivaroxaban, apixaban, edoxaban to reduce the risk of stroke and systemic embolism in patients with AF. There is limited literature to support the use of DOACs in cancer patients, but they are being prescribed by medical professionals nonetheless. Therefore, additional research is necessary to determine the effectiveness of the DOACs in cancer patients, to quantify their bleeding risks, and to identify patients that are more likely to benefit from these new medications in comparison to warfarin. Large randomized clinical trials of DOACs compared to warfarin in cancer patients have not been performed. Our aim was to determine the effectiveness and associated risk of DOACs vs. warfarin in a large, real-world population of cancer patients with AF. Methods We identified 532,743 AF patients initiating oral anticoagulant use in 2010-2014 continuously enrolled in MarketScan databases. We selected 41,036 cancer patients with inpatient or outpatient ICD9 code 140.x-172.x and 174.x-209.x (excluded 173.x, non-melanoma skin cancer), and then identified a subset of cancer patients being actively treated at the time of anticoagulant initiation. Active cancer patients were defined by the use of chemotherapy, radiation therapy or cancer surgery within 6 months prior to the start of anticoagulation. Patients were categorized according to the first anticoagulant prescribed after AF diagnosis. DOAC users were matched with warfarin users by age (±3 years), sex, enrollment date (90 days), and anticoagulant initiation date (90 days). Study endpoints, including ischemic stroke, severe bleeding (intracranial hemorrhage, gastrointestinal bleeding), other bleeding (genitourinary bleeding, hemopericardium, hemarthrosis, epistaxis, hemoptysis and unspecified hemorrhage) and VTE were identified using inpatient diagnostic codes, and VTE was additionally identified from 2 outpatient diagnostic codes within the same year. Cox proportional hazards models were used to access the association between type of anticoagulant and outcomes adjusting for high-dimensional propensity score, age, sex, CHA2DS2-VASc score, and the prevalent outcome. Results The demographic profile of the patients included in the analysis are depicted in Table 1, and Table 2 summarizes the outcomes data. In this analysis there were 6,075 cancer patients with AF who were on DOACs (rivaroxaban 2808, dabigatran 2189, and apixaban 1078) compared to 10,021 on warfarin, with a mean age of 74 years, and a mean follow-up time of 1 year. Approximately 40% of the patients were woman, and breast cancer was the most common cancer in each cohort. We found that for rivaroxaban and dabigatran users, the adjusted hazard ratios for severe bleeding was non significantly different to warfarin users, however, apixaban users had a lower risk of severe bleeding compared to warfarin users, with a hazard ratio 0.37 (95% confidence interval 0.17-0.79, p=0.01). The risk of other bleeding was lower in dabigatran users compared to warfarin users with a hazard ratio 0.58 (95% confidence interval 0.41-0.84, p=0.003). The risk of ischemic stroke did not differ significantly amongst different anticoagulant users. Each of the DOACs was superior to warfarin in lowering the risk of incident VTE, with p values < 0.0001. Conclusion Based on this analysis the DOACs seem to be well tolerated in cancer patients in regard to the management of atrial fibrillation, with lower or similar rates of bleeding and stroke compared to warfarin users. Importantly, the DOAC users had a significantly lower risk of incident VTE. Given that VTE events contribute to significant morbidity and mortality in cancer patients, prescription of DOACs in place of warfarin can be considered in cancer patients with AF, while we are awaiting prospective data from randomized trials. Disclosures No relevant conflicts of interest to declare.

scholarly journals Hospital and clinical care costs associated with atrial fibrillation for Medicare beneficiaries in the Cardiovascular Health Study and the Framingham Heart Study

2018 ◽  
Vol 6 ◽  
pp. 205031211875944 ◽  
Author(s):  
Joseph AC Delaney ◽  
Xiaoyan Yin ◽  
João Daniel Fontes ◽  
Erin R Wallace ◽  
Asheley Skinner ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Confidence Interval ◽  
Framingham Heart Study ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Heart Study ◽  
Care Costs ◽  
Onset Atrial Fibrillation ◽  
New Onset

Background: Atrial fibrillation is increasingly prevalent as the US population ages and is associated with significant morbidity and mortality. Care for patients with atrial fibrillation can be costly, US health care costs are comparatively high, and there are few cost estimates available that incorporate detailed measurement of comorbidities and their effects on costs. Methods and Results: In the Cardiovascular Health Study and the Framingham Heart Study, participants aged 65 years or older with newly diagnosed atrial fibrillation were matched on age and follow-up time to referents free of atrial fibrillation. The total clinical and hospital medical costs paid by Medicare Parts A and B (drug costs from Medicare Part D costs were not included) in the year prior to diagnosis (or matching) were compared with costs in the following year. Estimates were adjusted for other medical conditions and adjusted to 2009 dollars. In the Cardiovascular Health Study, 513 participants were diagnosed with new-onset atrial fibrillation and survived 30 days post-atrial fibrillation diagnosis, and 513 referents (as a control cohort) were identified, with a mean age of 77 years. In the Framingham Heart Study, we identified 336 participants diagnosed with atrial fibrillation, who survived 30 days post-atrial fibrillation diagnosis and matched these participants to 336 referents. We compared these new-onset atrial fibrillation participants with referents, using a difference in difference design to account for both time trends and differences between the two groups. The adjusted incremental cost for participants with atrial fibrillation, compared with referents, was US$18,060 (95% confidence interval: US$14,965–US$21,155) in the Cardiovascular Health Study and US$20,012 (95% confidence interval: US$15,057–US$24,966) in the Framingham Heart Study. The pooled estimate was US$18,601 (95% confidence interval: US$15,981–US$21,234). Conclusion: Atrial fibrillation was associated with increased costs in the year after diagnosis in two community-based cohorts, even after careful accounting for age, time period, and systematically measured comorbidities.

scholarly journals Life"s simple 7 and the risk of stroke in Finnish men: a prospective cohort study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
N Isiozor ◽  
SK Kunutsor ◽  
A Voutilainen ◽  
S Kurl ◽  
J Kauhanen ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischaemic Stroke ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Cox Regression ◽  
Smoking Status ◽  
Population Based ◽  
P Value ◽  
Cardiovascular Research ◽  
History Of

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): North Savo Regional Fund and Finnish Foundation for Cardiovascular Research Background Population-wide preventive measures constitute important approaches toward reducing stroke risk and its associated burden. We sought to examine the association between American Heart Association’s (AHA) Life’s Simple7 (LS7) score and the risk of stroke in men. Methods The study is based on the prospective population-based Kuopio Ischaemic Heart Disease cohort comprising men (42-60 years) without pre-existing history of stroke at baseline. LS7 was computed from AHA’s cardiovascular health metrics for 2520 men and includes data on diet, physical activity, body mass index, smoking status, blood pressures, total cholesterol and blood glucose. Participants were classified into three LS7 groups based on the number of ideal metrics: inadequate (0–2), average (3–4) and optimal (5–7). Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of LS7 scores for total and ischaemic stroke. Results During a median follow-up of 26years, 428 total and 362 ischaemic incident stroke events were recorded. The risk of both stroke outcomes decreased continuously with increasing LS7 scores across the range 2 to 6. Men with optimal LS7 had 48% (HR: 0.52; 95%CI: 0.32–0.86) lower risk of total stroke when compared with those with inadequate LS7. The association was similar for the risk of ischaemic stroke, with 50% (HR: 0.50; 95%CI: 0.29–0.87) lower risk among men with an optimal LS7 compared with those with inadequate LS7. Conclusion LS7 was strongly, inversely and linearly associated with risk of total and ischaemic strokes among a middle-aged male Caucasian population. Life’s Simple 7 and the risk of stroke Total Stroke Ischaemic Stroke LS7 score 0-2† (inadequate) 3-4 (average) 5-7 (optimal) 0-2† (inadequate) 3-4 (average) 5-7 (optimal) n/N 224/1109 187/1273 17/138 192/1109 156/1273 14/138 Model 1 HR (95%CI) 1 0.65 (0.53 - 0.79) 0.49 (0.30 - 0.81) 1 0.63 (0.51 - 0.78) 0.47 (0.27 - 0.82) p value* &lt;0.001 0.005 &lt;0.001 0.007 Model 2 HR (95%CI) 1 0,69 (0.56 - 0.84) 0.52 (0.32 - 0.86) 1 0.67 (0.54 - 0.84) 0.50 (0.29 - 0.87) p value* &lt;0.001 0.01 &lt;0.001 0.014 n/N, number of events/Total; HR, hazard ratio; CI, Confidence interval *p-values for the HRs &lt;0.05 are considered statistically significant †Reference category Model 1: adjusted for age, alcohol consumption and socioeconomic status Model 2: Model 1 plus history of coronary heart disease and history of type 2 diabetes mellitus

scholarly journals Presence of Atrial Fibrillation in Stroke Patients With Patent Foramen Ovale: Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Jessie Ze-Jun Chen ◽  
Vincent N. Thijs
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Confidence Interval ◽  
Lower Risk ◽  
Patent Foramen Ovale ◽  
Cryptogenic Stroke ◽  
Foramen Ovale ◽  
Stroke Patients ◽  
Loop Recorder ◽  
Cross Sectional

Purpose: Patent foramen ovale (PFO) is associated with ischemic stroke, especially in patients with embolic stroke of undetermined source. This study aims to evaluate the presence of atrial fibrillation (AF) in ischemic stroke patients with PFO.Methods: We systematically searched EMBASE and MEDLINE databases on May 21, 2020 for studies that analyzed the presence of AF in patients with PFO. The primary outcome was the presence of AF in patients with PFO compared with those without. Outcomes were pooled using a random-effects model using the method of DerSimonian and Laird. We recorded demographic characteristics and the methods used for AF detection in the studies included (unspecified, history/medical records review, ECG, Holter monitor, or loop recorder).Results: A total of 14 studies and 13,245 patients fulfilled the entry criteria. The average age was 61.2 years and 41.3% of the participants were female. There was a lower risk of AF in patients with PFO compared with those without (RR 0.52, 95% confidence interval, 0.41–0.63, p &lt; 0.001). There was no evidence of heterogeneity. The lower risk of AF was found in cross-sectional and longitudinal studies and in studies stratified by average age (&lt;60 or ≥60) and in cryptogenic stroke. Meta-regression by PFO detection technique suggested that studies using transoesophageal echocardiogram for PFO detection reported higher risk of AF (1.39, 95% confidence interval 1.14–1.70, p = 0.004).Conclusion: The presence of a PFO in patients with ischemic stroke/TIA may be associated with a lower risk of AF. Few studies have estimated the risk of future AF in patients with PFO.

Abstract P004: Association Between The Liver Fibrosis-4 Score And Incident Atrial Fibrillation In A General Japanese Population Of Middle-aged To Older Adults

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Yoshihiro Tanaka ◽  
Sarah Chuzi ◽  
Nagisa Morikawa ◽  
Hayato Tada ◽  
Kenshi Hayashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Liver Fibrosis ◽  
Cumulative Incidence ◽  
Japanese Population ◽  
General Japanese Population ◽  
Increased Risk ◽  
Longitudinal Association ◽  
Cox Proportional Hazard Models

Background: There is increasing evidence that end-organ liver dysfunction is an important risk factor for atrial fibrillation (AF). Whether a non-invasive, laboratory-based marker of liver fibrosis, the fibrosis-4 score (FIB-4), is associated with incident AF is not known. Aim: To examine the longitudinal association of FIB-4 with incident AF in a general Japanese population with public health insurance. Methods: We used data from the National Japanese Health Check-Up performed in Kanazawa City, which included unemployed or retired participants aged ≥ 40 years. The baseline examination occurred in 2013 and participants were invited for annual routine examinations with follow-up data available through 2018. We excluded participants with pre-existing AF or missing data at baseline or follow-up. Incident AF was based on 12-lead electrocardiogram. We calculated the FIB-4 score (composed of age [years], aspartate and alanine aminotransferase, and platelet levels) for each participant and estimated the cumulative incidence of AF stratified by FIB-4 score quartiles. We also examined the association between quartiles of FIB-4 and incident AF using Cox proportional hazard models adjusted for risk factors with the lowest FIB-4 quartile as referent. Results: Of 37,892 participants, 37% were male and mean age was 72.4±9.6 years. Median (interquartile range [IQR]) of the FIB-4 score was 1.75 (IQR 1.38, 2.27). During a median (IQR) follow-up period of 5.0 years (4.0, 5.0), 707 cases of incident AF were identified. Cumulative incidence in the highest quartile of FIB-4 was 3.9% compared with 1.0% in the lowest quartile (log-rank p<0.001, Figure A ). Higher quartiles of the FIB-4 score had a dose-dependent increased risk of AF with adjusted HR of 1.70 (1.29, 2.23) in the highest quartile compared with the lowest quartile ( Figure B ). Conclusion: FIB-4 was independently associated with incident AF in a general, older Japanese population and may reflect risk of AF, in addition to traditional cardiovascular risk factors.

Abstract 11637: Physical Activity and Atrial Fibrillation: Results From the Multi-ethnic Study of Atherosclerosis (MESA)

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Aneesh Bapat ◽  
Saman Nazarian ◽  
Alvaro Alonso ◽  
Yiyi Zhang ◽  
Wendy Post ◽  
...  
Keyword(s):  
Physical Activity ◽  
Atrial Fibrillation ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Vigorous Physical Activity ◽  
Cvd Risk ◽  
Cox Models ◽  
Ethnic Study ◽  
Farm Work ◽  
Increased Risk

Introduction: Prior studies have raised the question of whether an association exists between physical activity (PA) and atrial fibrillation (AF), with mixed results. We sought to use the Multi-Ethnic Study of Atherosclerosis (MESA) database to examine the association between PA and AF in a diverse population without clinically recognized prevalent cardiovascular disease (CVD). Hypothesis: Increased exercise will have a protective influence on AF incidence. Methods: MESA participants (N=5793) with a completed baseline PA survey and complete covariate data were included. Incident AF events were determined based on hospital discharge ICD-9 codes and Medicare inpatient claims. Total intentional exercise (TIE), defined as a sum of walking for exercise, dance/sport, and conditioning, was used as our independent variable of interest. The MESA population was stratified based on whether they reported participation in any vigorous physical activity (VPA), which was defined as “heavy effort” expended in household chores, lawn/yard/garden/farm work, conditioning activities, and occupational/volunteering work. Cox models, adjusted for demographics and CVD risk factors, were used to determine hazard ratios (HR) for incident AF based on total intentional exercise (TIE) for the subgroups. We performed similar analyses using TIE as a categorical variable stratified into tertiles. Results: During a mean follow-up of 7.7±1.9 years, 199 AF cases occurred. In the overall MESA population, TIE alone was not associated with incident AF. However, within the group that reported any VPA (N=1866), there was a statistically significant protective influence of increasing TIE on incident AF (HR=0.658, p=0.014). Additionally, among the same group, the top tertile of TIE was associated with a significantly lower risk of incident AF compared with the group with no TIE (HR=0.48, p=0.048). Conclusions: TIE was associated with a lower risk of incident AF among those that participated in any VPA, and this protective influence was most notable among those that performed the most TIE. Perhaps as importantly, no subgroup of participants demonstrated an increased risk of incident AF with TIE. These results re-emphasize the beneficial role of exercise for cardiovascular health.

scholarly journals Association of Changes in Cardiovascular Health Metrics and Risk of Subsequent Cardiovascular Disease and Mortality

2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Bamba Gaye ◽  
Gabriel S. Tajeu ◽  
Ramachandran S. Vasan ◽  
Camille Lassale ◽  
Norrina B. Allen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Smoking Status ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
All Cause Mortality ◽  
Stable Ideal ◽  
Incident Cardiovascular Disease ◽  
Over Time

Background The extent to which change in cardiovascular health (CVH) in midlife reduces risk of subsequent cardiovascular disease and mortality is unclear. Methods and Results CVH was computed at 2 ARIC (Atherosclerosis Risk in Communities) study visits in 1987 to 1989 and 1993 to 1995, using 7 metrics (smoking, body mass index, total cholesterol, blood glucose, blood pressure, physical activity, and diet), each classified as poor, intermediate, and ideal. Overall CVH was classified as poor, intermediate, and ideal to correspond to 0 to 2, 3 to 4, and 5 to 7 metrics at ideal levels. There 10 038 participants, aged 44 to 66 years that were eligible. From the first to the second study visit, there was an improvement in overall CVH for 17% of participants and a decrease in CVH for 21% of participants. At both study visits, 28%, 27%, and 6% had poor, intermediate, and ideal overall CVH, respectively. Compared with those with poor CVH at both visits, the risk of cardiovascular disease (hazard ratio [HR], 0.26; 95% CI, 0.20–0.34) and mortality (HR, 0.35; 95% CI, 0.29–0.44) was lowest in those with ideal CVH at both measures. Improvement from poor to intermediate/ideal CVH was also associated with a lower risk of cardiovascular disease (HR, 0.67; 95% CI, 0.59–0.75) and mortality (HR, 0.80; 95% CI, 0.72–0.89). Conclusions Improvement in CVH or stable ideal CVH, compared with those with poor CVH over time, is associated with a lower risk of incident cardiovascular disease and all‐cause mortality. The change in smoking status and cholesterol may have accounted for a large part of the observed association.

scholarly journals Gender-specific relationship between abdominal obesity and prevalence of new-onset atrial fibrillation in the general Japanese population

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Ninomiya ◽  
S Kawasoe ◽  
H Ichiki ◽  
T Kubozono ◽  
H Miyahara ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Waist Circumference ◽  
Abdominal Obesity ◽  
Japanese Population ◽  
Univariate Analysis ◽  
General Japanese Population ◽  
Increased Risk ◽  
Near Future ◽  
New Onset

Abstract Background The number of incidences of atrial fibrillation (AF) is expected to rise rapidly in the near future because of the increased number of geriatric patients in Japanese society. In addition, obesity is increasing in the general Japanese population. Although a higher body mass index is associated with a higher risk of AF, the relationship between abdominal obesity (large waist circumference) and new-onset AF is unclear. Methods and results We performed a longitudinal retrospective observational study from January 2007 to October 2018 using the annual health checkup data. Data from 58,844 adults (29,572 males, age 54±13 years) without baseline AF, who underwent routine health checkups, were analyzed. We performed logistic regression analyses to determine the strength of the association between abdominal obesity and new-onset AF. We also examined the effect of abdominal obesity on the incidences of AF stratified by gender. During a median follow-up of 4 years, we recorded new cases of AF in 322 (0.5%) individuals. In univariate analysis, a large waist circumference was significantly associated with new-onset AF, both in males [hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.02 to 1.05, p&lt;0.001] and in females (HR 1.04, 95% CI 1.01 to 1.06, p=0.002), respectively. In multivariate analysis adjusted for clinical variables (age, hypertension, dyslipidemia, estimated glomerular filtration rate, habitual drinking and diabetes), a large waist circumference was significantly and independently associated with new-onset AF in males (HR 1.04, 95% CI 1.03 to 1.06, p&lt;0.001), but not in females (HR 1.01, 95% CI 0.99 to 1.04, p=0.269). Conclusion Abdominal obesity is independently associated with an increased risk of new-onset AF in males. This association in males might imply some sex-specific mechanisms. There might be a gender difference in the effectiveness of interventions to decrease abdominal obesity to prevent AF. Funding Acknowledgement Type of funding source: None

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