{"id":"6ff4ea4b3d23","type":"article","url":"https://hartvaat.nl/2026/01/20/af-screening-naar-genetisch-risico-loop-subanalyse/","title":"AF-screening naar genetisch risico: LOOP subanalyse","title_en":"Atrial Fibrillation Screening According to Genetic Risk: A Secondary Analysis of the Randomized LOOP Study.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog","huisarts"],"tags":["primaire-preventie"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2025.09.024","source_url":"https://doi.org/10.1016/j.jacc.2025.09.024","authors":["Oliver B Vad","Søren Z Diederichsen","Lucas Y Xing","Christian Paludan-Müller","Laia M Monfort","Gustav Ahlberg","Laura Andreasen","Ketil J Haugan","Claus Graff","Søren Højberg","Derk Krieger","Axel Brandes","Lars Køber","Jesper H Svendsen"],"significance":6,"published":"2026-01-20","source_date":"2026-01-20","image":"","kennis":[],"congress":"","summary_en":"This LOOP subanalysis showed that higher genetic risk scores for AF increase the yield of systematic arrhythmia screening, supporting a genetics-enriched approach to targeted AF detection programs.","created":"2026-07-03T10:32:07Z","updated":"2026-07-03T13:31:05Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"LOOP subanalyse onderzocht of genetisch risico de opbrengst van AF-screening beïnvloedt. Hogere genetische risicoscores waren geassocieerd met meer AF-detectie, wat gerichte screening kan informeren.","abstract_original":"BACKGROUND: Polygenic risk scores (PRS) hold promise in risk stratification and screening for cardiovascular diseases, including atrial fibrillation (AF). OBJECTIVES: This study investigated the efficacy of AF screening for stroke prevention based on a PRS for AF. METHODS: This prespecified post hoc analysis of the randomized LOOP (Atrial Fibrillation Detected by Continuous ECG Monitoring Using Implantable Loop Recorder to Prevent Stroke in High-Risk Individuals) study included 5,656 AF-naive individuals aged ≥70 years with stroke risk factors and available genetic data. The participants were randomized 1:3 for screening with an implantable loop recorder (ILR) vs usual care. Genetic risk of AF was assessed using a PRS for AF (PRSAF). The primary outcome was a composite of stroke and systemic embolism (SE). Interaction between the randomization arm and PRSAF was assessed in cause-specific Cox regressions for the full cohort and across the observed range of polygenic risk using a continuous prediction grid. Secondary analyses included models stratified by PRS level, gene-screening interactions for major bleeding events, and associations between PRSAF and AF burden (≥1 episode lasting ≥24 hours among participants with ILR-detected AF). RESULTS: Over a median follow-up period of 5.4 years, 969 participants (17.1%) received a diagnosis of AF, 296 (5.2%) had stroke/SE, and 206 (3.6%) had major bleeding. PRSAF was associated with higher rates of AF (HR per SD increase: 1.20; 95% CI: 1.13-1.28; P < 0.001). A significant interaction was observed between ILR screening and PRSAF for stroke/SE (Pinteraction = 0.006). ILR screening was associated with lower rates of stroke/SE in individuals with PRSAF ≥median (HR: 0.65; 95% CI: 0.43-0.97; P = 0.036) but not in those with PRSAF <median (HR: 1.06; 95% CI: 0.72-1.57; P = 0.75). ILR screening was associated with higher rates of major bleeding at lower levels of PRSAF (Pinteraction = 0.036), corresponding to a HR of 1.71 (95% CI: 1.12-2.64; P = 0.011) in those with PRSAF <median. A 1-SD increase in PRSAF was associated with an OR of 1.35 (95% CI: 1.02-1.78; P = 0.037) for having ≥1 AF episode lasting ≥24 hours. CONCLUSIONS: 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. These hypothesis-generating findings indicate that genetic predisposition may aid in selecting individuals who benefit from AF screening."}