Plasminogen activator inhibitor-1 and tissue plasminogen activator and incident AF: Data from the PREVEND study

Abstract

Background: Tissue-type plasminogen activator (TPA) and plasminogen activator inhibitor-1 (PAI-1) have been shown to be associated with increased risk for stroke, however, the association with incident atrial fibrillation (AF) is unknown. Methods: We examined 8265 individuals included in the PREVEND study. In all subjects, PAI-1 and TPA plasma/serum levels were measured using an ELISA kit. By means of univariate and multivariate analyses the association with incident AF was assessed. Results: Mean age was age 49 ± 13 years, and 50% were women. Of the 8265 patients free of AF at baseline, 267 (3.2%) patients developed incident AF during a mean follow-up of 9.7 ± 2.4 years. Baseline median levels of PAI-1 and TPA were 72.4 ng/ml and 3.1 ng/ml, respectively. In univariate analyses PAI-1 (Hazard ratio [HR] 1.10 95% Confidence interval [CI] 1.04–1.16, p < 0.001) and TPA (HR 1.05, 95% CI 1.01–1.08, p = 0.014) were associated with incident AF. However, after multivariate adjustment for age, sex, antihypertensive drugs, stroke, heart failure, myocardial infarction, diabetes mellitus, peripheral arterial disease, smoking, NT-proBNP, alcohol consumption, body mass index no significant association was found. Conclusion: In this community-based cohort, PAI-1 and TPA levels were not associated with incident AF.