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White Blood Cell Count and Risk of Incident Atrial Fibrillation (From the Framingham Heart Study)

  • Michiel Rienstra
    Affiliations
    Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts

    Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University, Framingham, Massachusetts
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  • Jenny X. Sun
    Affiliations
    Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
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  • Jared W. Magnani
    Affiliations
    Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University, Framingham, Massachusetts

    Cardiology Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
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  • Moritz F. Sinner
    Affiliations
    Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts

    Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University, Framingham, Massachusetts

    Department of Medicine I, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Germany
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  • Steven A. Lubitz
    Affiliations
    Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, Massachusetts
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  • Lisa M. Sullivan
    Affiliations
    Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
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  • Author Footnotes
    † Drs. Ellinor and Benjamin contributed equally to this article.
    Patrick T. Ellinor
    Footnotes
    † Drs. Ellinor and Benjamin contributed equally to this article.
    Affiliations
    Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts

    Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, Massachusetts
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  • Author Footnotes
    † Drs. Ellinor and Benjamin contributed equally to this article.
    Emelia J. Benjamin
    Correspondence
    Corresponding author: Tel: (617) 638-8968; fax: (508) 626-1262
    Footnotes
    † Drs. Ellinor and Benjamin contributed equally to this article.
    Affiliations
    Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University, Framingham, Massachusetts

    Cardiology Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts

    Preventive Medicine Section, Boston University School of Medicine, Boston, Massachusetts

    Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
    Search for articles by this author
  • Author Footnotes
    † Drs. Ellinor and Benjamin contributed equally to this article.
Published:November 21, 2011DOI:https://doi.org/10.1016/j.amjcard.2011.09.049
      Several studies have reported that inflammatory markers are associated with atrial fibrillation (AF). The white blood cell (WBC) count is a widely available and broadly used marker of systemic inflammation. We sought to investigate the association between an increased WBC count and incident AF and whether this association is mediated by smoking, myocardial infarction, and heart failure. We examined the participants in the Framingham Heart Study original cohort. Cox proportional hazard regression analysis was used to examine the relation between the WBC count and incident AF during a 5-year follow-up period. We adjusted for standard AF risk factors, smoking, previous myocardial infarction, and interim myocardial infarction and heart failure before the incident AF. Our sample consisted of 936 participants (mean age 76 ± 6 years and 61% women). The median WBC count was 6.4 × 109/L (25th to 75th percentile 5.6 × 109/L to 7.8 × 109/L). During a median 5-year follow-up period, 82 participants (9%) developed new-onset AF. After adjusting for standard risk factors for AF, an increased WBC count was significantly associated with incident AF, with a hazard ratio per SD (0.26 × 109/L) increase of 2.22 (95% confidence interval 1.10 to 4.48; p = 0.03). We found no substantive differences adjusting for smoking, previous myocardial infarction, interim myocardial infarction, or heart failure. In conclusion, in our community-based sample, an increased WBC count was associated with incident AF during 5 years of follow-up. Our findings provide additional evidence for the relation between systemic inflammation and AF.
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