A multimarker approach to assess the influence of inflammation on the incidence of atrial fibrillation in women

Eur Heart J. 2010 Jul;31(14):1730-6. doi: 10.1093/eurheartj/ehq146. Epub 2010 May 25.


Aims: To assess the joint influence of inflammatory biomarkers on the risk of incident atrial fibrillation (AF) in women.

Methods and results: We performed a prospective cohort study among women participating in the Women's Health Study. All women were free of AF at study entry and provided a baseline blood sample assayed for high-sensitivity C-reactive protein, soluble intercellular adhesion molecule-1, and fibrinogen. To evaluate the joint effect of these three biomarkers, an inflammation score was created that ranged from 0 to 3 and reflected the number of biomarkers in the highest tertile per individual. During a median follow-up of 14.4 years, 747 of 24,734 women (3.0%) experienced a first AF event. Assessed individually, all three biomarkers were associated with incident AF, even after adjustment for traditional risk factors. When combined into an inflammation score, a strong and independent relationship between inflammation and incident AF emerged. Across increasing inflammation score categories, there were 1.66, 2.22, 2.73, and 3.25 AF events per 1000 person-years of follow-up. The corresponding hazard ratios (95% confidence intervals) across inflammation score categories were 1.0, 1.22 (1.00-1.49), 1.32 (1.06-1.65), and 1.59 (1.22-2.06) (P for linear trend 0.0006) after multivariable adjustment.

Conclusion: In this large-scale prospective study among women without a history of cardiovascular disease, markers of systemic inflammation were significantly related to AF even after controlling for traditional risk factors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / etiology*
  • Biomarkers / metabolism
  • C-Reactive Protein / metabolism*
  • Female
  • Fibrinogen / metabolism*
  • Humans
  • Inflammation / metabolism
  • Intercellular Adhesion Molecule-1 / metabolism*
  • Middle Aged
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Risk Factors


  • Biomarkers
  • Intercellular Adhesion Molecule-1
  • Fibrinogen
  • C-Reactive Protein