{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:05:34Z","timestamp":1782299134370,"version":"3.54.5"},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,3,24]],"date-time":"2018-03-24T00:00:00Z","timestamp":1521849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2018,6]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Link between inflammation and atrial fibrillation (AF<\/jats:styled-content>) has been increasingly recognized. Neopterin, a biomarker of cellular immune activation, may be associated with incident AF<\/jats:styled-content>.<\/jats:p><\/jats:sec>Objective<\/jats:title>To investigate the association between plasma neopterin levels and risk of an inpatient hospital diagnosis of AF<\/jats:styled-content>, and to evaluate a joint association of neopterin and a nonspecific inflammatory marker C\u2010reactive protein (CRP<\/jats:styled-content>) in two prospective cohorts.<\/jats:p><\/jats:sec>Methods<\/jats:title>We performed a prospective analysis from a community\u2010based cohort (the Hordaland Health Study (HUSK<\/jats:styled-content>), n<\/jats:italic> = 6891), and validated the findings in a cohort of patients with suspected stable angina pectoris (the Western Norway Coronary Angiography Cohort (WECAC<\/jats:styled-content>), n<\/jats:italic> = 2022).<\/jats:p><\/jats:sec>Results<\/jats:title>In both cohorts, higher plasma levels of neopterin were associated with an increased risk of incident AF<\/jats:styled-content> after adjustment for age, sex, body mass index, current smoking, diabetes, hypertension and renal function. The multivariable\u2010adjusted hazard ratio (HR<\/jats:styled-content>) (95% CI<\/jats:styled-content>) per one SD<\/jats:styled-content> increment of log\u2010transformed neopterin was 1.20 (1.10\u20131.32) in HUSK<\/jats:styled-content> and 1.26 (1.09\u20131.44) in WECAC<\/jats:styled-content>. Additional adjustment for CRP<\/jats:styled-content> did not materially affect the risk association for neopterin. The highest risk of AF<\/jats:styled-content> was found among individuals with both neopterin and CRP<\/jats:styled-content> levels above the median (HR<\/jats:styled-content>: 1.54; 95% CI<\/jats:styled-content>: 1.16\u20132.05 in HUSK<\/jats:styled-content> and HR<\/jats:styled-content>: 1.67; 95% CI<\/jats:styled-content>: 1.11\u20132.52 in WECAC<\/jats:styled-content>).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Our findings indicate an association of plasma neopterin with risk of an inpatient hospital diagnosis of AF<\/jats:styled-content>, which remains after adjustment for traditional risk factors as well as for CRP<\/jats:styled-content>. This study highlights a role of cellular immune activation, in addition to inflammation, in AF<\/jats:styled-content> pathogenesis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/joim.12748","type":"journal-article","created":{"date-parts":[[2018,3,24]],"date-time":"2018-03-24T12:58:29Z","timestamp":1521896309000},"page":"578-587","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Association of plasma neopterin with risk of an inpatient hospital diagnosis of atrial fibrillation: results from two prospective cohort studies"],"prefix":"10.1111","volume":"283","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3918-5754","authenticated-orcid":false,"given":"H.","family":"Zuo","sequence":"first","affiliation":[{"name":"Department of Global Public Health and Primary Care University of Bergen Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Nyg\u00e5rd","sequence":"additional","affiliation":[{"name":"Department of Clinical Science University of Bergen Bergen Norway"},{"name":"Department of Heart Disease Haukeland University Hospital Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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