The association of exhaled carbon monoxide with atrial fibrillation and left atrial size in the Framingham Heart Study

Authors

Oseiwe B. Eromosele, Department of Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, USA.
Ayelet Shapira-Daniels, Department of Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, USA.
Amy Yuan, Department of Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, USA.
Abdulkareem Lukan, Advocate Health - MidwestFollow
Olumuyiwa Akinrimisi, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA 94305, USA.
Marius Chukwurah, Department of Medicine, Division of Cardiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Matthew Nayor, Department of Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, USA.
Emelia J. Benjamin, Department of Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, USA.
Honghuang Lin, Boston University and NHLBI's Framingham Heart Study, USA.

Recommended Citation

Eromosele OB, Shapira-Daniels A, Yuan A, et al. The association of exhaled carbon monoxide with atrial fibrillation and left atrial size in the Framingham Heart Study. Am Heart J Plus. 2024;45:100439. Published 2024 Aug 8. doi:10.1016/j.ahjo.2024.100439

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Background:Exhaled carbon monoxide (eCO) is associated with subclinical and overt cardiovascular disease and stroke. The association between eCO with left atrial size, prevalent, or incident atrial fibrillation (AF) are uncertain.

Methods:eCO was measured using an Ecolyzer instrument among Framingham Heart Study Offspring and Omni participants who attended an examination from 1994 to 1998. We analyzed multivariable-adjusted (current smoking, and other covariates including age, race, sex, height, weight, systolic blood pressure, diastolic blood pressure, diabetes, hypertension treatment, prevalent myocardial infarction [MI], and prevalent heart failure [HF]). Cox and logistic regression models assessed the relations between eCO and incident AF (primary model), and prevalent AF and left atrial (LA) size (pre-specified secondary analyses). We also conducted secondary analyses adjusting for biomarkers, and interim MI and interim HF.

Results:Our study sample included 3814 participants (mean age 58 ± 10 years; 54.4 % women, 88.4 % White). During an average of 18.8 ± 6.5 years follow-up, 683 participants were diagnosed with AF. eCO was associated with incident AF after adjusting for established AF risk factors (HR, 1.31 [95 % CI, 1.09-1.58]). In secondary analyses the association remained significant after additionally adjusting for C-reactive protein and B-type natriuretic peptide, and interim MI and CHF, and in analyses excluding individuals who currently smoked. eCO was not significantly associated with LA size and prevalent AF.

Conclusion:In our community-based sample of individuals without AF, higher mean eCO concentrations were associated with incident AF. Further investigation is needed to explore the biological mechanisms linking eCO with AF.

Document Type

Article

PubMed ID

39234302