Familial Aggregation of Atrial Fibrillation

Author:

Christophersen Ingrid Elisabeth1,Ravn Lasse Steen1,Budtz-Joergensen Esben1,Skytthe Axel1,Haunsoe Stig1,Svendsen Jesper Hastrup1,Christensen Kaare1

Affiliation:

1. From The Danish National Research Foundation Centre for Cardiac Arrhythmia (I.E.C., L.S.R., S.H., J.H.S.), Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; the Danish Twin Register, Institute of Public Health (A.S., K.C.), University of Southern Denmark, Odense, Denmark; Department of Biostatistics (E.B.-J.), University of Copenhagen, Copenhagen, Denmark; and the Department of Surgery and Medicine (S.H., H.S.), Faculty of Health Sciences, University of...

Abstract

Background— Heritability may play a role in nonfamilial atrial fibrillation (AF). We hypothesized that a monozygotic (MZ) twin whose co-twin was diagnosed with AF would have an increased risk of the disease compared with a dizygotic (DZ) twin in the same situation. Methods and Results— A sample of 1137 same-sex twin pairs (356 MZ and 781 DZ pairs) in which one or both members were diagnosed with AF were identified in The Danish Twin Registry. Concordance rates were twice as high for MZ pairs than for DZ pairs regardless of sex (22.0% versus 11.6%, P <0.0001). In a Cox regression of event-free survival times, we compared the time span between occurrences of disease in MZ and DZ twins. The unaffected twin was included when his or her twin-sibling (the index twin) was diagnosed with AF. After adjustment for age at entry, MZ twins had a significantly shorter event-free survival time (hazard ratio, 2.0; 95% CI, 1.3 to 3.0), thereby indicating a genetic component. Using biometric models, we estimated the heritability of AF to be 62% (55% to 68%), due to additive genetics. There were no significant differences across sexes. Conclusions— All the analyses of twin similarities in the present study indicate that genetic factors play a substantial role in the risk of AF for both sexes. The recurrence risk for co-twins (12% to 22%) is clinically relevant and suggests that co-twins of AF-affected twins belong to a high-risk group for AF.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

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