{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:50:40Z","timestamp":1781880640209,"version":"3.54.5"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T00:00:00Z","timestamp":1637193600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Atrial fibrillation (AF) has a heterogeneous pathophysiology according to individual patient characteristics. This study aimed to identify the effects of widely known risk factors on AF incidence according to age and to elucidate the clinical implications of these effects.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods and results<\/jats:title>\n<jats:p>We analyzed data from 501,668 subjects (\u226518years old) without AF and valvular heart disease from the Korean National Health Insurance Service-National Sample Cohort. The total population was divided into two groups according to age, &lt;60years and \u226560years. AF occurred in 0.7% of the overall population (3,416 of 501,668) during the follow-up period (mean 47.6 months). In Cox regression analysis, age, male sex, previous ischemic stroke, heart failure, and hypertension were related to increased risk of new-onset AF in both age groups. Especially in the &lt;60years age group, risk of new-onset AF was increased by relatively modifiable risk factors: obesity (body mass index \u226525kg\/m<jats:sup>2<\/jats:sup>; hazard ratio[HR] 1.37 [1.22\u20131.55], p&lt;0.001, interaction p&lt;0.001), and hypertension (HR 1.93[1.69\u20132.22], p&lt;0.001, interaction p&lt;0.001). Although interactions were not significant, chronic obstructive pulmonary disease (HR 1.41[1.24\u20131.60], p&lt;0.001) and chronic kidney disease (HR 1.28[1.15\u20131.41], p&lt;0.001) showed increased trends of the risk of new-onset AF in the \u226560years age group.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The risk profile for new-onset AF was somewhat different between the &lt;60years and the \u226560years age groups. Compared to the \u226560years group, relatively modifiable risk factors (such as obesity and hypertension) had a greater impact on AF incidence in the &lt;60years age group. Different management strategies to prevent AF development according to age may be needed.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0258770","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T18:54:28Z","timestamp":1637261668000},"page":"e0258770","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparison of risk profiles for new-onset atrial fibrillation between patients aged &lt;60 and \u226560 years"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2801-5514","authenticated-orcid":true,"given":"In-Soo","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeon-Jik","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eui-Young","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pil-Ki","family":"Min","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Won","family":"Yoon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byoung Kwon","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bum-Kee","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se-Joong","family":"Rim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyuck Moon","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7040-8771","authenticated-orcid":true,"given":"Jong-Youn","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,11,18]]},"reference":[{"key":"pone.0258770.ref001","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS).","author":"G Hindricks","year":"2020","journal-title":"Eur Heart J"},{"key":"pone.0258770.ref002","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.hlc.2017.05.119","article-title":"Pathophysiology of Paroxysmal and Persistent Atrial Fibrillation: Rotors, Foci and Fibrosis","volume":"26","author":"DH Lau","year":"2017","journal-title":"Heart Lung Circ"},{"key":"pone.0258770.ref003","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1093\/eurheartj\/ehv375","article-title":"Novel mechanisms in the pathogenesis of atrial fibrillation: practical applications","volume":"37","author":"DH Lau","year":"2016","journal-title":"Eur Heart J"},{"key":"pone.0258770.ref004","article-title":"Associations of Abdominal Obesity and New-Onset Atrial Fibrillation in the General Population","volume":"6","author":"YS Baek","year":"2017","journal-title":"J Am Heart Assoc"},{"key":"pone.0258770.ref005","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1161\/CIRCRESAHA.114.303211","article-title":"The clinical profile and pathophysiology of atrial fibrillation: relationships among clinical features, epidemiology, and mechanisms","volume":"114","author":"J Andrade","year":"2014","journal-title":"Circ Res"},{"key":"pone.0258770.ref006","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1161\/CIRCRESAHA.117.309732","article-title":"Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes","volume":"120","author":"L Staerk","year":"2017","journal-title":"Circ Res"},{"key":"pone.0258770.ref007","doi-asserted-by":"crossref","first-page":"158.e151","DOI":"10.1016\/j.amjmed.2013.10.005","article-title":"The Impact of Age on the Epidemiology of Atrial Fibrillation Hospitalizations","volume":"127","author":"S Naderi","year":"2014","journal-title":"The American Journal of Medicine"},{"key":"pone.0258770.ref008","first-page":"799","article-title":"Data Resource Profile: The National Health Information Database of the National Health Insurance Service in South Korea","volume":"46","author":"S Cheol Seong","year":"2017","journal-title":"Int J Epidemiol"},{"key":"pone.0258770.ref009","first-page":"e15","article-title":"Cohort Profile: The National Health Insurance Service-National Sample Cohort (NHIS-NSC), South Korea","volume":"46","author":"J. 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