Abstract P082: Association Of Breast Arterial Calcification With Atrial Fibrillation Among Postmenopausal Women

• Published in: Circulation (New York, N.Y.) Vol. 145; no. Suppl_1
• Main Authors: Iribarren, Carlos, Chandra, Malini, Parikh, Rishi V, Sanchez, Gabriela, Sam, Danny L, Azamian, Farima F, Cho, Hyo-Min, Ding, Huanjun, Molloi, Sabee, Go, Alan S
• Format: Journal Article
• Language: English
• Published: 01.03.2022
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.145.suppl_1.P082

Abstract only Coronary artery calcium (CAC) is independently associated with incident atrial fibrillation (AF). Breast arterial calcification (BAC), commonly seen in mammograms, correlates with CAC and cardiovascular outcomes. However, whether BAC is associated with AF is unknown. We examined the association of BAC presence and gradation with prevalent or incident AF in the MINERVA cohort of 5,059 post-menopausal women (60-79 years), free of clinical cardiovascular disease, recruited after mammography screening at Kaiser Permanente Northern California between 2012-2015. Incident AF cases were identified between entry and 12/31/2020, and prevalent cases up to 5 years before entry. Both prevalent and incident AF were ascertained using hospital discharge diagnostic and outpatient ICD-9 and ICD-10 codes plus natural language processing of ECG reports and progress notes in the electronic health record. We measured the quantity of BAC using a densitometry method. A total of 469 AF events were ascertained during 6.5 years of follow-up (132 prevalent, 335 incident). In multivariable logistic regression adjusting for age and ethnicity (Model 1), BAC presence (BAC > 0 mg) vs absence (BAC=0 mg) was associated with 1.26 (95% CI:1.02-1.55; p=0.03) increased odds of prevalent or incident AF; further adjustment for body mass index, hypertension, diabetes, cholesterol lowering drugs, anticoagulant use, hs-CRP, e-GFR, sleep apnea and early menopause increased the strength of association between BAC and AF. However, there was no clear dose-response association, although women in the upper tertile of BAC when BAC was present exhibited the highest odds of prevalent or incident AF (adjusted OR=1.91; 95% CI=1.43-2.57; p=<0.001). In sensitivity analysis restricting to incident AF events, the independent association persisted (data not shown). In conclusion, presence of mammographic BAC and more severe BAC may provide additional useful information for AF risk among postmenopausal women.