Subclinical Measures of Peripheral Atherosclerosis and the Risk of New-Onset Atrial Fibrillation in the General Population: the Rotterdam Study.

Background Limited population-based data on the (sex-specific) link between subclinical measures of peripheral atherosclerosis and new-onset atrial fibrillation (AF) exist. Methods and Results Subclinical measures of peripheral atherosclerosis including carotid intima-media thickness (cIMT), carotid plaque, and ankle-brachial index (ABI) were assessed at baseline and follow-up examinations. A total of 12 840 participants free of AF at baseline from the population-based Rotterdam Study were included. Cox proportional hazards models and joint models, adjusted for cardiovascular risk factors, were used to determine the associations between baseline and longitudinal measures of cIMT, carotid plaque, and ABI with new-onset AF. During a median follow-up of 9.2 years, 1360 incident AF cases occurred among 12 840 participants (mean age 65.2 years, 58.3% women). Higher baseline cIMT (fully-adjusted hazard ratio [HR], 95% CI, 1.81, 1.21-2.71;