Accelerated Biological Aging and Risk of Atrial Fibrillation: A Cohort Study

Background: Even though aging has been demonstrated to be associated with a higher risk of atrial fibrillation (AF). It is unclear whether biological aging is associated with risk of incident AF.

Objective: This study aims to investigate the association between biological aging and AF.

Methods: A total of 371,882 participants without AF at baseline from the UK Biobank were included. The incident AF was ascertained through linkage to the UK National Health Services register. Biological age was evaluated from clinical traits using the Klemera-Doubal method Biological Age (KDM-BA) and PhenoAge algorithm, respectively. The residual discrepancies between biological age with chronological age were defined as the age accelerations (KDM-BA acceleration and PhenoAge acceleration). The Cox proportional hazards model was used to evaluate the effects of age accelerations with the risk of incident AF.

Results: During a mean follow-up of 13.04 years, a total of 28,076 new cases of AF were identified. Accelerated biological age was associated with an increased risk of AF, with a hazard ratio (HR) of 1.11 (95% confidence intervals [CIs] 1.10 - 1.13) per standard deviations (SD) increase in KDM-BA acceleration (10.9 years), and 1.28 (95%CI 1.27 - 1.30) in PhenoAge acceleration (5.6 years), respectively.

Conclusion: Accelerated biological age quantified by clinical biomarkers is associated with increased risks of AF. Biological aging may represent a potential risk factor for incident AF in midlife and older adults and a potential target for risk assessment and intervention.