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. 2009 Aug;2(4):378-83.
doi: 10.1161/CIRCEP.108.786665. Epub 2009 Apr 23.

Familial aggregation of atrial fibrillation: a study in Danish twins

Ingrid Elisabeth Christophersen  1 , Lasse Steen Ravn, Esben Budtz-Joergensen, Axel Skytthe, Stig Haunsoe, Jesper Hastrup Svendsen, Kaare Christensen
Affiliations

Familial aggregation of atrial fibrillation: a study in Danish twins

Ingrid Elisabeth Christophersen et al. Circ Arrhythm Electrophysiol. 2009 Aug.

Abstract

Background: Heritability may play a role in nonfamilial atrial fibrillation (AF). We hypothesized that a monozygotic (MZ) twin whose co-twin was diagnosed with AF would have an increased risk of the disease compared with a dizygotic (DZ) twin in the same situation.

Methods and results: A sample of 1137 same-sex twin pairs (356 MZ and 781 DZ pairs) in which one or both members were diagnosed with AF were identified in The Danish Twin Registry. Concordance rates were twice as high for MZ pairs than for DZ pairs regardless of sex (22.0% versus 11.6%, P<0.0001). In a Cox regression of event-free survival times, we compared the time span between occurrences of disease in MZ and DZ twins. The unaffected twin was included when his or her twin-sibling (the index twin) was diagnosed with AF. After adjustment for age at entry, MZ twins had a significantly shorter event-free survival time (hazard ratio, 2.0; 95% CI, 1.3 to 3.0), thereby indicating a genetic component. Using biometric models, we estimated the heritability of AF to be 62% (55% to 68%), due to additive genetics. There were no significant differences across sexes.

Conclusions: All the analyses of twin similarities in the present study indicate that genetic factors play a substantial role in the risk of AF for both sexes. The recurrence risk for co-twins (12% to 22%) is clinically relevant and suggests that co-twins of AF-affected twins belong to a high-risk group for AF.

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Figures

Figure 1
Figure 1
Plot of cumulative incidence of atrial fibrillation as a function of zygosity for both genders analyzed together. CI=confidence interval.
See this image and copyright information in PMC

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