Arrhythmias & electrophysiologySecondary analysis
Atrial Fibrillation Screening According to Genetic Risk
- Secondary analysis of the LOOP randomised trial
- prespecified post hoc analysis
Authors' conclusion
ILR screening for AF was associated with a significant reduction in stroke/SE in individuals with higher genetic risk of AF but not in those with lower genetic risk.
Study context
- Population
- Atrial fibrillation (AF)-naive individuals aged ≥70 years with stroke risk factors and available genetic datarandomized 1:3
- Participants
- 5,656 individuals
- Comparison
- Implantable loop recorder (ILR) screening vs usual care, by polygenic risk score for AF
- Primary endpoint
- Stroke or systemic embolism
Primary result
As reported in the abstract
Stroke/SE by PRSAF · median follow-up 5.4 years
ILR vs Usual careHazard ratio (95% CI)P value
PRSAF ≥median
0.65(0.43–0.97)
P = 0.036PRSAF <median
1.06(0.72–1.57)
P = 0.75Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| AF diagnosis by PRSAF | HR 1.20 (95% CI 1.13–1.28) | P < 0.001 | |
| ≥1 AF episode lasting ≥24 hours (ILR-detected AF) | OR 1.35 (95% CI 1.02–1.78) | P = 0.037 | |
| 0.512Ratio (log scale) |
- AF diagnosis by PRS for AF (PRSAF): 969 participants (17.1%) received a diagnosis of AF
Safety
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Major bleeding by PRSAF · PRSAF <median | 1.71 (1.12–2.64) | P = 0.011 | |
| 0.20.5125Hazard ratio (log scale) |
- Major bleeding by PRSAF: Pinteraction = 0.036
- Major bleeding by PRSAF: 206 (3.6%) had major bleeding
Original publication
Atrial Fibrillation Screening According to Genetic Risk. J Am Coll Cardiol. Published 29 October 2025. doi:10.1016/j.jacc.2025.09.024
Summarised from the published abstract; every number is checked against it