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Sex-based Approach for the Clinical Impact of the Increased Hemoglobin on Incident AF in the General Population.

Authors
  • Kim, In Soo1
  • Lee, Byoung Kwon1
  • Yang, Pil Sung2
  • Joung, Boyoung3
  • Kim, Jong Youn4
  • 1 Division of Cardiology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. , (North Korea)
  • 2 Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea. , (North Korea)
  • 3 Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. , (North Korea)
  • 4 Division of Cardiology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. [email protected] , (North Korea)
Type
Published Article
Journal
Korean circulation journal
Publication Date
Dec 01, 2020
Volume
50
Issue
12
Pages
1095–1110
Identifiers
DOI: 10.4070/kcj.2020.0412
PMID: 33258318
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Although the adverse cardiovascular effect of anemia has been well described, the effect of polycythemia on the incident atrial fibrillation (AF) remain unclear. The objective of this study is to identify the association between increased hemoglobin and incident AF. This was a retrospective-cohort study with 434,269 subjects who underwent national health examinations from the Korean National Sample Cohort. We estimated the risk of incident AF according to hemoglobin-based four-categories. During 3.9-year of follow-up, polycythemia group showed higher incidences of AF (hazard ratio[HR] with 95% confidence interval[CI], 1.50 [1.28-1.76] and 1.69 [1.13-2.56]; in men and women, respectively) than normal hemoglobin group (each p<0.001). In the normal hemoglobin and polycythemia groups, a 1 g/dL increase in hemoglobin level was associated with increased risks of incident AF (1.12 [1.07-1.17] and 1.18 [1.10-1.26] in men and women, each p<0.001). To investigate the specific hemoglobin concentration related to greater AF incidence, we analyzed the sensitivity/specificity of different hemoglobin levels: ≥16.0 g/dL in men and ≥14.5 g/dL in women showed the highest Youden's index, with c-indices of 0.83 and 0.82, respectively. Kaplan-Meier cumulative-event curves according to these specific hemoglobin levels (≥16.0 g/dL in men and ≥14.5 g/dL in women) also showed consistent results in both sexes (each p<0.05). Even in the Korean general population, increased hemoglobin was significantly associated with higher rate of incident AF. Especially, subjects with hemoglobin levels ≥14.5 g/dL in women and ≥16.0 g/dL among men were associated with increased risk of incident AF. Copyright © 2020. The Korean Society of Cardiology.

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