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In Reply: We agree with Drs Korantzopoulos and Kolettis that inflammation is another potentially important mechanism linking obesity and AF. Cross-sectional studies^1-2 have shown an association between C-reactive protein levels and AF, and a longitudinal study demonstrated that C-reactive protein levels predicted the development of AF over a mean follow-up of 7 years in the Cardiovascular Health Study cohort.³ Obese individuals may have elevated C-reactive protein levels.⁴ Thus, it is plausible that systemic inflammation contributes to the increased risk of AF observed in obese individuals. Because C-reactive protein levels were not routinely measured at our baseline examinations, we were unable to investigate this interesting hypothesis.

Regarding Dr Parish’s question, the person-level data showed that 1 woman had AF a week before year 16. For the numbers at risk listed below the Kaplan-Meier figure, we collapsed the data by month; hence, that person is included in the year 16 column. At . . . [Full Text of this Article]

Thomas J. Wang, MD
Massachusetts General Hospital
Harvard Medical School
Boston

Helen Parise, ScD
Department of Mathematics
Boston University

Lisa M. Sullivan, PhD; Ralph B. D’Agostino Sr, PhD
The Framingham Heart Study
Boston University

Daniel Levy, MD
The Framingham Heart Study
National Heart, Lung, and Blood Institute
Bethesda, Md

Philip A. Wolf, MD; Ramachandran S. Vasan, MD; Emelia J. Benjamin, MD, ScD
emelia@bu.edu
The Framingham Heart Study
Boston University School of Medicine

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