{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:28:44Z","timestamp":1784248124282,"version":"3.55.0"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Sustained forms of atrial fibrillation (AF) are associated with lower treatment success rates and poorer prognosis compared with paroxysmal AF. Yet, little is known about risk factors that predispose to persistent AF on initial presentation. Our objective was to define risk factors associated with new-onset persistent AF.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>We prospectively examined the differential associations between lifestyle, clinical, and socioeconomic risk factors and AF pattern (persistent versus paroxysmal) at the time of diagnosis among 25\u2005119 participants without a history of cardiovascular disease, AF, or cancer in the VITAL rhythm study (Vitamin D and Omega-3).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              During a median follow-up of 5.3 years, 900 participants developed AF and 346 (38.4%) were classified as persistent at the time of diagnosis. In multivariable competing risk models, increasing age, male sex, White race, height, weight, body mass index \u226530 kg\/m\n              <jats:sup>2<\/jats:sup>\n              , hypertension, current or past smoking, alcohol intake \u22652 drinks\/day, postcollege education, and randomized treatment with vitamin D were significantly associated with incident persistent AF. Compared with paroxysmal AF, increasing age, male sex, weight, body mass index \u226530 kg\/m\n              <jats:sup>2<\/jats:sup>\n              , and postcollege education were more strongly associated with persistent AF in multivariable models regardless of whether interim cardiovascular disease and heart failure events were censored.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>In a prospective cohort without baseline AF or cardiovascular disease, over one-third of AF at the time of diagnosis is persistent. Older age, male sex, postcollege education, and obesity were preferentially associated with persistent AF and represent a high-risk AF subset for population-based intervention.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.123.012334","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T10:00:26Z","timestamp":1701252026000},"page":"651-662","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Risk Factors for the Development of New-Onset Persistent Atrial Fibrillation: Subanalysis of the VITAL Study"],"prefix":"10.1161","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4106-9771","authenticated-orcid":true,"given":"Melissa E.","family":"Middeldorp","sequence":"first","affiliation":[{"name":"Department of Cardiology, Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA (M.E.M., R.K.S., J.M., C.M.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2629-3476","authenticated-orcid":true,"given":"Roopinder K.","family":"Sandhu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA (M.E.M., R.K.S., J.M., C.M.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA (M.E.M., R.K.S., J.M., C.M.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8954-9694","authenticated-orcid":true,"given":"Baris","family":"Gencer","sequence":"additional","affiliation":[{"name":"Cardiology Division, Geneva University Hospitals, Switzerland (B.G.)."},{"name":"Institute of Primary Health Care (BIHAM), University of Bern, Switzerland (B.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline S.","family":"Danik","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston. 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