Abstract 18418: Insulin Resistance Does Not Increase Risk Of Incident Atrial Fibrillation: The Framingham Heart Study

Background: Atrial Fibrillation (AF) is the most common chronic arrhythmia and it causes significant morbidity and mortality. Diabetes and obesity are increasing in prevalence and are associated with elevated risk of atrial fibrillation (AF). Whether insulin resistance is an intermediate step for the development of AF is uncertain. We hypothesized that insulin resistance (IR) is associated with an increased risk of incident AF. Methods: We evaluated 7,338 Framingham Heart Study Offspring participants who attended either the fifth (1991-1994) or seventh (1998-2001) examination cycles. We excluded 534 participants with missing homeostatic model assessment index (HOMA-IR), 624 participants with diabetes, 144 with AF at or prior to baseline exam and 1,463 under the age of 50. IR was defined as the top quartile of HOMA-IR index. We examined the association of IR to incident AF with multivariable Cox proportional hazard models adjusting for established AF risk factors using the 3 models described in the Table. Results: Of the 4583 eligible participants (55% women; mean age 59 years), 279 developed AF over up to 10 years. In all three models IR was not significantly associated with incident AF. Conclusions: In this study, we did not observe a significant association between IR and incident AF. Given the increasing burdens of diabetes and AF, the intermediate pathways between these two entities merits continued attention.