Socioeconomic deprivation is linked to adverse cardiovascular outcomes, but its combined effect with genetic predisposition on incident atrial fibrillation (AF) remains uncertain. This study published in European Journal of Preventive Cardiology assessed the combined effects of socioeconomic deprivation and genetic risk on incident AF.

Participants without prior AF from the UK Biobank were included. Socioeconomic deprivation was defined as the top 5% of the Index of Multiple Deprivation (IMD). Genetic risk was quantified using a polygenic risk score (PRS) for AF. The primary outcome was incident AF. Findings were replicated in an independent South Korean cohort.

Among 425,423 participants (mean age 56.5±8.1 years; 45.2% male), 21,264 were classified as socioeconomically deprived. The deprived group was younger and had a higher burden of comorbidities. AF incidence was higher in deprived versus non-deprived individuals (5.8 vs 4.7 per 1,000 person-years), with an adjusted hazard ratio (aHR) of 1.16 (95% confidence interval [CI] 1.09–1.24; P<0.001). Most IMD components, except housing and living environment, were associated with increased AF risk (aHR range 1.13–1.19). The association between deprivation and AF was stronger in individuals with low genetic risk (lowest PRS tertile: aHR 1.36 [1.19–1.56]) than in those with high genetic risk (highest PRS tertile: aHR 1.11 [1.01–1.22]; interaction P=0.0013). Results were consistent in the Korean cohort (n=7,898).

Socioeconomically deprived individuals had a significantly higher risk of AF, with this risk influenced by genetic predisposition. Targeted public health policies and personalized AF screening for high-risk groups may help lessen the burden of AF and improve cardiovascular health.