Genetic risk factors for postoperative atrial fibrillation—a nationwide genome-wide association study (GWAS)

BACKGROUND: Atrial fibrillation (AF) is a major cause of morbidity with a high prevalence among the elderly and has an established genetic disposition. Surgery is a well-known risk factor for AF; however, it is currently not recognized how much common genetic variants influence the postoperative risk. The purpose of this study was to identify Single Nucleotide Polymorphisms associated with postoperative AF. METHODS: The UK Biobank was utilized to conduct a Genome-Wide Association Study (GWAS) to identify variants associated with AF after surgery. An initial discovery GWAS was performed in patients that had undergone surgery with subsequent replication in a unique non-surgical cohort. In the surgical cohort, cases were defined as newly diagnosed AF within 30 days after surgery. The threshold for significance was set at 5 × 10(−8). RESULTS: After quality control, 144,196 surgical patients with 254,068 SNPs were left for analysis. Two variants (rs17042171 (p = 4.86 × 10(−15)) and rs17042081 (p = 7.12 × 10(−15))) near the PITX2-gene reached statistical significance. These variants were replicated in the non-surgical cohort (1.39 × 10(−101) and 1.27 × 10(−93), respectively). Several other loci were significantly associated with AF in the non-surgical cohort. CONCLUSION: In this GWAS-analysis of a large national biobank, we identified 2 variants that were significantly associated with postoperative AF. These variants were subsequently replicated in a unique non-surgical cohort. These findings bring new insight in the genetics of postoperative AF and may help identify at-risk patients and guide management.