Familial Aggregation of Atrial Fibrillation: A Study in Danish Twins
Open accessAbstract
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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Several studies evaluating familial aggregation of AF have reported substantially increased risk of AF in individuals with affected family members.
“Several studies evaluating familial aggregation of AF have reported substantially increased risk of AF in individuals with affected family members.8,9,50–55”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [53]
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References 27 · Cited by 209
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- [26]Arnar DO Thorvaldsson S Manolio TA Thorgeirsson G Kristjansson K Hakonarson H Stefansson K Familial aggregation of atrial fibrillation in Iceland Eur Heart J 2006 27 708 712 16428254
- [29]Gudbjartsson DF Arnar DO Helgadottir A Gretarsdottir S Holm H Sigurdsson A Jonasdottir A Baker A Thorleifsson G Kristjansson K Palsson A Blondal T Sulem P Backman VM Hardarson GA Palsdottir E Helgason A Sigurjonsdottir R Sverrisson JT Kostulas K Ng MC Baum L So WY Wong KS Chan JC Furie KL Greenberg SM Sale M Kelly P MacRae CA Smith EE Rosand J Hillert J Ma RC Ellinor PT Thorgeirsson G Gulcher JR Kong A Thorsteinsdottir U Stefansson K Variants conferring risk of atrial fibrillation on chromosome 4q25 Nature 2007 448 353 357 17603472
- Authors
- Christophersen, I. E., Ravn, L. S., Budtz-Joergensen, E., Skytthe, A., Haunsoe, S., Svendsen, J. H., & Christensen, K.
- Affiliations
- University of Copenhagen (DK)
- From The Danish National Research Foundation Centre for Cardiac Arrhythmia (I.E.C., L.S.R., S.H., J.H.S.), Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; the Danish Twin Register, Institute of Public Health (A.S., K.C.), University of Southern Denmark, Odense, Denmark; Department of Biostatistics (E.B.-J.), University of Copenhagen, Copenhagen, Denmark; and the Department of Surgery and Medicine (S.H., H.S.), Faculty of Health Sciences, University of...
- Venue
- Circulation: Arrhythmia and Electrophysiology
- Published
- 2009-08
- Volume
- 2
- Issue
- 4
- Pages
- 378-383
- ISSN
- 1941-3084 (ISSN-L)
- 1941-3149
- PMC
- PMC2760022
- OpenAlex
- W1972057415
- Cited by
- 209
- References
- 27
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 14 · 2023: 12 · 2022: 7 · 2021: 7 · 2020: 17 · 2019: 8 · 2018: 10 · 2017: 17 · 2016: 13 · 2015: 10 · 2014: 17 · 2013: 17 · 2012: 17
- FWCI
- 9.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation Arrhythmia and Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- PubMed Central (acceptedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- National Institute on Aging (P01AG008761)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- atrial fibrillation, familial aggregation, heritability, monozygotic twins, dizygotic twins, concordance, recurrence risk, additive genetic effects
- MeSH terms
- Aged, Aged, 80 and over, Atrial Fibrillation, Biometry, Denmark, Family Health, Female, Humans, Male, Middle Aged, Models, Genetic, Registries, Risk Factors, Twins, Dizygotic, Twins, Monozygotic, Incidence, Prevalence, Proportional Hazards Models
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