Genetic mutations in African patients with atrial fibrillation: Rationale and design of the Study of Genetics of Atrial Fibrillation in an African Population (SIGNAL)

Gerald S. Bloomfield, Tecla M. Temu, Constantine O. Akwanalo, Peng Sheng Chen, Wilfred Emonyi, Susan R. Heckbert, Myra M. Koech, Imran Manji, Changyu Shen, Matteo Vatta, Eric J. Velazquez, Jennifer Wessel, Sylvester Kimaiyo, Thomas S. Inui

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background There is an urgent need to understand genetic associations with atrial fibrillation in ethnically diverse populations. There are no such data from sub-Saharan Africa, despite the fact that atrial fibrillation is one of the fastest growing diseases. Moreover, patients with valvular heart disease are underrepresented in studies of the genetics of atrial fibrillation. Methods We designed a case-control study of patients with and without a history of atrial fibrillation in Kenya. Cases with atrial fibrillation included those with and without valvular heart disease. Patients underwent clinical phenotyping and will have laboratory analysis and genetic testing of >240 candidate genes associated with cardiovascular diseases. A 12-month follow-up assessment will determine the groups' morbidity and mortality. The primary analyses will describe genetic and phenotypic associations with atrial fibrillation. Results We recruited 298 participants: 72 (24%) with nonvalvular atrial fibrillation, 78 (26%) with valvular atrial fibrillation, and 148 (50%) controls without atrial fibrillation. The mean age of cases and controls were 53 and 48 years, respectively. Most (69%) participants were female. Controls more often had hypertension (45%) than did those with valvular atrial fibrillation (27%). Diabetes and current tobacco smoking were uncommon. A history of stroke was present in 25% of cases and in 5% of controls. Conclusion This is the first study determining genetic associations in valvular and nonvalvular atrial fibrillation in sub-Saharan Africa with a control population. The results advance knowledge about atrial fibrillation and will enhance international efforts to decrease atrial fibrillation-related morbidity.

Original languageEnglish (US)
Pages (from-to)455-464.e5
JournalAmerican Heart Journal
Volume170
Issue number3
DOIs
StatePublished - Sep 1 2015

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Atrial Fibrillation
Mutation
Population
Heart Valve Diseases
Africa South of the Sahara
Morbidity
Kenya
Genetic Testing
Genetic Association Studies
Case-Control Studies
Cardiovascular Diseases
Smoking
Stroke
Hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Genetic mutations in African patients with atrial fibrillation : Rationale and design of the Study of Genetics of Atrial Fibrillation in an African Population (SIGNAL). / Bloomfield, Gerald S.; Temu, Tecla M.; Akwanalo, Constantine O.; Chen, Peng Sheng; Emonyi, Wilfred; Heckbert, Susan R.; Koech, Myra M.; Manji, Imran; Shen, Changyu; Vatta, Matteo; Velazquez, Eric J.; Wessel, Jennifer; Kimaiyo, Sylvester; Inui, Thomas S.

In: American Heart Journal, Vol. 170, No. 3, 01.09.2015, p. 455-464.e5.

Research output: Contribution to journalArticle

Bloomfield, GS, Temu, TM, Akwanalo, CO, Chen, PS, Emonyi, W, Heckbert, SR, Koech, MM, Manji, I, Shen, C, Vatta, M, Velazquez, EJ, Wessel, J, Kimaiyo, S & Inui, TS 2015, 'Genetic mutations in African patients with atrial fibrillation: Rationale and design of the Study of Genetics of Atrial Fibrillation in an African Population (SIGNAL)', American Heart Journal, vol. 170, no. 3, pp. 455-464.e5. https://doi.org/10.1016/j.ahj.2015.06.008
Bloomfield, Gerald S. ; Temu, Tecla M. ; Akwanalo, Constantine O. ; Chen, Peng Sheng ; Emonyi, Wilfred ; Heckbert, Susan R. ; Koech, Myra M. ; Manji, Imran ; Shen, Changyu ; Vatta, Matteo ; Velazquez, Eric J. ; Wessel, Jennifer ; Kimaiyo, Sylvester ; Inui, Thomas S. / Genetic mutations in African patients with atrial fibrillation : Rationale and design of the Study of Genetics of Atrial Fibrillation in an African Population (SIGNAL). In: American Heart Journal. 2015 ; Vol. 170, No. 3. pp. 455-464.e5.
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abstract = "Background There is an urgent need to understand genetic associations with atrial fibrillation in ethnically diverse populations. There are no such data from sub-Saharan Africa, despite the fact that atrial fibrillation is one of the fastest growing diseases. Moreover, patients with valvular heart disease are underrepresented in studies of the genetics of atrial fibrillation. Methods We designed a case-control study of patients with and without a history of atrial fibrillation in Kenya. Cases with atrial fibrillation included those with and without valvular heart disease. Patients underwent clinical phenotyping and will have laboratory analysis and genetic testing of >240 candidate genes associated with cardiovascular diseases. A 12-month follow-up assessment will determine the groups' morbidity and mortality. The primary analyses will describe genetic and phenotypic associations with atrial fibrillation. Results We recruited 298 participants: 72 (24{\%}) with nonvalvular atrial fibrillation, 78 (26{\%}) with valvular atrial fibrillation, and 148 (50{\%}) controls without atrial fibrillation. The mean age of cases and controls were 53 and 48 years, respectively. Most (69{\%}) participants were female. Controls more often had hypertension (45{\%}) than did those with valvular atrial fibrillation (27{\%}). Diabetes and current tobacco smoking were uncommon. A history of stroke was present in 25{\%} of cases and in 5{\%} of controls. Conclusion This is the first study determining genetic associations in valvular and nonvalvular atrial fibrillation in sub-Saharan Africa with a control population. The results advance knowledge about atrial fibrillation and will enhance international efforts to decrease atrial fibrillation-related morbidity.",
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T1 - Genetic mutations in African patients with atrial fibrillation

T2 - Rationale and design of the Study of Genetics of Atrial Fibrillation in an African Population (SIGNAL)

AU - Bloomfield, Gerald S.

AU - Temu, Tecla M.

AU - Akwanalo, Constantine O.

AU - Chen, Peng Sheng

AU - Emonyi, Wilfred

AU - Heckbert, Susan R.

AU - Koech, Myra M.

AU - Manji, Imran

AU - Shen, Changyu

AU - Vatta, Matteo

AU - Velazquez, Eric J.

AU - Wessel, Jennifer

AU - Kimaiyo, Sylvester

AU - Inui, Thomas S.

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Background There is an urgent need to understand genetic associations with atrial fibrillation in ethnically diverse populations. There are no such data from sub-Saharan Africa, despite the fact that atrial fibrillation is one of the fastest growing diseases. Moreover, patients with valvular heart disease are underrepresented in studies of the genetics of atrial fibrillation. Methods We designed a case-control study of patients with and without a history of atrial fibrillation in Kenya. Cases with atrial fibrillation included those with and without valvular heart disease. Patients underwent clinical phenotyping and will have laboratory analysis and genetic testing of >240 candidate genes associated with cardiovascular diseases. A 12-month follow-up assessment will determine the groups' morbidity and mortality. The primary analyses will describe genetic and phenotypic associations with atrial fibrillation. Results We recruited 298 participants: 72 (24%) with nonvalvular atrial fibrillation, 78 (26%) with valvular atrial fibrillation, and 148 (50%) controls without atrial fibrillation. The mean age of cases and controls were 53 and 48 years, respectively. Most (69%) participants were female. Controls more often had hypertension (45%) than did those with valvular atrial fibrillation (27%). Diabetes and current tobacco smoking were uncommon. A history of stroke was present in 25% of cases and in 5% of controls. Conclusion This is the first study determining genetic associations in valvular and nonvalvular atrial fibrillation in sub-Saharan Africa with a control population. The results advance knowledge about atrial fibrillation and will enhance international efforts to decrease atrial fibrillation-related morbidity.

AB - Background There is an urgent need to understand genetic associations with atrial fibrillation in ethnically diverse populations. There are no such data from sub-Saharan Africa, despite the fact that atrial fibrillation is one of the fastest growing diseases. Moreover, patients with valvular heart disease are underrepresented in studies of the genetics of atrial fibrillation. Methods We designed a case-control study of patients with and without a history of atrial fibrillation in Kenya. Cases with atrial fibrillation included those with and without valvular heart disease. Patients underwent clinical phenotyping and will have laboratory analysis and genetic testing of >240 candidate genes associated with cardiovascular diseases. A 12-month follow-up assessment will determine the groups' morbidity and mortality. The primary analyses will describe genetic and phenotypic associations with atrial fibrillation. Results We recruited 298 participants: 72 (24%) with nonvalvular atrial fibrillation, 78 (26%) with valvular atrial fibrillation, and 148 (50%) controls without atrial fibrillation. The mean age of cases and controls were 53 and 48 years, respectively. Most (69%) participants were female. Controls more often had hypertension (45%) than did those with valvular atrial fibrillation (27%). Diabetes and current tobacco smoking were uncommon. A history of stroke was present in 25% of cases and in 5% of controls. Conclusion This is the first study determining genetic associations in valvular and nonvalvular atrial fibrillation in sub-Saharan Africa with a control population. The results advance knowledge about atrial fibrillation and will enhance international efforts to decrease atrial fibrillation-related morbidity.

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