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Author Notes:

Address reprint requests and correspondence: Dr Arshed A. Quyyumi, Division of Cardiology, Emory University School of Medicine, Emory Clinical Cardiovascular Research Institute, 1462 Clifton Rd NE, Suite 507, Atlanta, GA 30322.

We thank Shuai Zheng, PhD, for his assistance with database.


Research Funding:

Dr Quyyumi was supported by the National Institutes of Health (grant nos. 5P01HL101398-02, 1P20HL113451-01, 1R56HL126558-01, 1RF1AG051633-01, R01 NS064162-01, R01 HL89650-01, HL095479-01, 1U10HL110302-01, 1DP3DK094346-01, and 2P01HL086773-06A1).

Dr Tahhan was supported by the Abraham J. & Phyllis Katz Foundation (Atlanta, GA) and the National Institutes of Health/National Institutes of Aging (grant no. AG051633).


  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Cardiovascular System & Cardiology
  • Atrial fibrillation
  • Oxidative stress
  • Glutathione
  • Redox potentials
  • Inflammation
  • RISK

Association between oxidative stress and atrial fibrillation

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Journal Title:

Heart Rhythm


Volume 14, Number 12


, Pages 1849-1855

Type of Work:

Article | Post-print: After Peer Review


Background Oxidative stress (OS) may be a key mechanism underlying the development of atrial fibrillation (AF) in experimental studies, but data in humans remain limited. Objective Systemic OS can be estimated by measurements of circulating levels of the aminothiols including glutathione, cysteine, and their oxidized products. We tested the hypothesis that the redox potentials of glutathione (EhGSH) and cysteine will be associated with prevalent and incident AF. Methods Plasma levels of aminothiols were measured in 1439 patients undergoing coronary angiography, of whom 148 (10.3%) had a diagnosis of AF. After a median follow-up of 6.3 years, 104 of 917 patients (11.5%) developed incident AF. Multivariate logistic regression and Cox regression models were used to determine whether OS markers were independent predictors of prevalent and incident AF after adjustment for traditional risk factors, heart failure, coronary artery disease, and high-sensitivity C-reactive protein level. Results For each 10% increase in EhGSH, the odds of prevalent AF was 30% higher (odds ratio [OR] 1.3; 95% confidence interval [CI] 1.1–1.7; P =.02) and 90% higher (OR 1.9; 95% CI 1.3–2.7; P =.004) when the median was used as a cutoff. The EhGSH level above the median was more predictive of chronic AF (OR 4.0; 95% CI 1.3–12.9; P =.01) than of paroxysmal AF (OR 1.7; 95% CI 1.1–2.7; P =.03). Each 10% increase in EhGSH level was associated with a 40% increase in the risk of incident AF (hazard ratio 1.4; 95% CI 1.1–1.7; P =.01). Conclusion Increased OS measured by the redox potentials of glutathione is associated with prevalent and incident AF. Therapies that modulate OS need to be investigated to treat and prevent AF.

Copyright information:

© 2017 Heart Rhythm Society

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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