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Low levels of plasma carotenoids are associated with an increased risk of atrial fibrillation

  • CARDIOVASCULAR DISEASE
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Abstract

Systemic inflammation, oxidative stress, and atrial fibrosis are identified as the main mechanisms for atrial fibrillation (AF). Antioxidant micronutrients may have antiarrhythmic benefit in humans. We studied whether plasma carotenoids are related to the risk of AF in elderly subjects. The study population consisted of 1,847 Finnish subjects (620 women and 1,227 men) aged 61–82 years from the Kuopio Ischaemic Heart Disease Risk Factor study cohort. Plasma concentrations of carotenoids were measured by high-performance liquid chromatography. The multivariable-adjusted hazard ratios (HRs) and 95 % confidence intervals (CIs) of plasma carotenoids were analyzed using the Cox proportional hazard’s model. During a median follow-up of 2.8 years a total of 105 subjects developed incident AF. The HRs of AF among subjects with levels in the highest through the lowest tertile after adjustment for age, examination year, gender, systolic blood pressure, smoking, alcohol consumption, education, diabetes, use of antihypertensive medication, congestive heart failure, recurrent AF, prevalent coronary heart disease and baseline prevalence of myocardial infarction were 1.70 (95 % CI: 1.01–2.86, p = 0.047) for lutein, 1.99 (95 % CI: 1.14–3.48, p = 0.016) for zeaxanthin. Risk of AF was borderline significant for β-carotene (HR = 1.69, 95 % CI: 1.00–2.87, p = 0.050). Results remained unchanged, when season was added to the multivariable model. Lycopene, β-cryptoxanthin, α-carotene and total carotenoids were not associated with the risk of AF. Results of the present study suggest that low plasma concentrations of lutein and zeaxanthin were associated with an increased risk of AF in elderly population.

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Acknowledgments

The authors are grateful to the staff of Institute of Public Health and Clinical Nutrition at the University of Eastern Finland for helping with data collection in the study. J.K. participated in study design, statistical analysis and drafted the manuscript and provided feedback on the work. S.K. participated in the design of the study and provided feedback on the work. T.H.M. participated in the design of the study. K.R. preformed statistical analyses. J.A.L. participated in the design of the study and provided feedback on the work. J.K., S.K. and J.A.L are responsible for the study. All authors collaborated interactively, and read and approved the final version of this article. S.K. will act as a guarantor for the paper. This work was supported by the EVO funding of Lapland Central Hospital and Orion-Farmos Research Foundation.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland

    Jouni Karppi, Sudhir Kurl, Kimmo Ronkainen & Jari Antero Laukkanen

  2. Division of Cardiology, Department of Internal Medicine, University of Oulu, Oulu, Finland

    Timo Heikki Mäkikallio

  3. Department of Internal Medicine, Lapland Central Hospital, Rovaniemi, Finland

    Jari Antero Laukkanen

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  1. Jouni Karppi
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  2. Sudhir Kurl
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Correspondence to Jouni Karppi.

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Karppi, J., Kurl, S., Mäkikallio, T.H. et al. Low levels of plasma carotenoids are associated with an increased risk of atrial fibrillation. Eur J Epidemiol 28, 45–53 (2013). https://doi.org/10.1007/s10654-012-9753-z

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  • DOI: https://doi.org/10.1007/s10654-012-9753-z

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