Obstructive Sleep Apnea, Obesity, and the Risk of Incident Atrial Fibrillation

Apoor S. Gami, Dave O. Hodge, Regina M. Herges, Eric J. Olson, Jiri Nykodym, Tomas Kara, Virend Somers

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Abstract

Objectives: This study sought to identify whether obesity and obstructive sleep apnea (OSA) independently predict incident atrial fibrillation/flutter (AF). Background: Obesity is a risk factor for AF, and OSA is highly prevalent in obesity. Obstructive sleep apnea is associated with AF, but it is unknown whether OSA predicts new-onset AF independently of obesity. Methods: We conducted a retrospective cohort study of 3,542 Olmsted County adults without past or current AF who were referred for an initial diagnostic polysomnogram from 1987 to 2003. New-onset AF was assessed and confirmed by electrocardiography during a mean follow-up of 4.7 years. Results: Incident AF occurred in 133 subjects (cumulative probability 14%, 95% confidence interval [CI] 9% to 19%). Univariate predictors of AF were age, male gender, hypertension, coronary artery disease, heart failure, smoking, body mass index, OSA (hazard ratio 2.18, 95% CI 1.34 to 3.54) and multiple measures of OSA severity. In subjects <65 years old, independent predictors of incident AF were age, male gender, coronary artery disease, body mass index (per 1 kg/m2, hazard ratio 1.07, 95% CI 1.05 to 1.10), and the decrease in nocturnal oxygen saturation (per 0.5 U log change, hazard ratio 3.29, 95% CI 1.35 to 8.04). Heart failure, but neither obesity nor OSA, predicted incident AF in subjects ≥65 years of age. Conclusions: Obesity and the magnitude of nocturnal oxygen desaturation, which is an important pathophysiological consequence of OSA, are independent risk factors for incident AF in individuals <65 years of age.

Original languageEnglish (US)
Pages (from-to)565-571
Number of pages7
JournalJournal of the American College of Cardiology
Volume49
Issue number5
DOIs
StatePublished - Feb 6 2007

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Atrial Flutter
Obstructive Sleep Apnea
Atrial Fibrillation
Obesity
Confidence Intervals
Coronary Artery Disease
Body Mass Index
Heart Failure
Oxygen
Electrocardiography
Cohort Studies
Retrospective Studies
Smoking
Hypertension

ASJC Scopus subject areas

  • Nursing(all)

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Obstructive Sleep Apnea, Obesity, and the Risk of Incident Atrial Fibrillation. / Gami, Apoor S.; Hodge, Dave O.; Herges, Regina M.; Olson, Eric J.; Nykodym, Jiri; Kara, Tomas; Somers, Virend.

In: Journal of the American College of Cardiology, Vol. 49, No. 5, 06.02.2007, p. 565-571.

Research output: Contribution to journalArticle

Gami, Apoor S. ; Hodge, Dave O. ; Herges, Regina M. ; Olson, Eric J. ; Nykodym, Jiri ; Kara, Tomas ; Somers, Virend. / Obstructive Sleep Apnea, Obesity, and the Risk of Incident Atrial Fibrillation. In: Journal of the American College of Cardiology. 2007 ; Vol. 49, No. 5. pp. 565-571.
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