Urine albumin excretion and the risk of incident atrial fibrillation: predictive or aetiological relevance?

I read with great interest the article by Marcoset al. investigating observational associations of urine albumin measures either by a simple urine albumin test or a more complex 24-h urine collection test with incident atrial fibrillation (AF) in an apparently healthy general population cohort enriched with individuals having an urine albumin concentration  >10 mg/L at baseline.1 In line with previously published epidemiological studies, the authors report a positive association between elevated urine albumin and an increased risk of incident AF. While the associations were independent of common and novel risk factors in prospective observations, but a possibility of unmeasured confounding or reverse causality cannot be ruled out. As the authors and others noted a complementary strand of evidence from a randomized clinical trial or its analog, called Mendelian randomization, needs to investigate whether the association between urine albumin and AF is causal or not. In this context, genetic evidence from available genome-wide association studies (GWAS) for urine albumin and AF or a meta-analysis of genome-wide genotype data from large cohorts can enhance the likelihood of causal or non-causal associations.2,3
Source: Europace - Category: Cardiology Source Type: research

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