γ-Butyrobetaine, L-carnitine and acylcarnitines and their association with incident atrial fibrillation among men and women with suspected chronic coronary syndrome.
5 affiliations
- 1Department of Heart Disease, Haukeland University Hospital, Pb 1400, Bergen 5021, Norway.
- 2Department of Clinical Science, University of Bergen, Pb 7804, Bergen 5020, Norway.
- 3Bevital AS, Minde Allé 35, Bergen 5068, Norway.
- 4Division of Diagnostics and Technology, Akershus University Hospital, Pb 1000, Lørenskog 1478, Norway.
- 5Department of Heart Disease, Stavanger University Hospital, Pb 8100, Stavanger 4068, Norway.
Abstract
Aims
Carnitine-metabolites play a key role in cell energy metabolism and have been implicated in the pathogenesis of atrial fibrillation (AF). However, any associations between L-carnitine and the precursor γ-butyrobetaine (γBB) with new-onset AF are not established. We therefore examined the relationship between serum γBB, L-carnitine and selected acylcarnitines with incident AF.Methods and results
We studied 3815 patients who underwent coronary angiography due to suspected chronic coronary syndrome and followed up for incident CVD events, including new-onset AF. Risk associations between the biomarkers and incident AF were explored by logistic regression for the total population and stratified according to sex. The majority (71.6%) of the patients were men, the median age was 61 years. Over a median follow-up of 7.3 years, 412 (10.8%) were reported with new-onset AF. In a multivariate model higher serum γBB, L-carnitine and palmitoylcarnitine [OR per 1SD (95% CI): 1.15 (1.01-1.31), P = 0.04; 1.14 (1.01-1.27), P = 0.03 and 1.15 (1.03-1.28), P = 0.01] were associated with increased risk of incident AF. These associations were particularly stronger among women (P for interaction < 0.04, all).Conclusion
In this large cohort of patients with suspected chronic coronary syndrome elevated circulating levels of γBB, L-carnitine and palmitoylcarnitine were associated with increased risk of incident AF, with stronger associations among women. Our results motivate further studies examining the relationship between carnitine metabolites and cardiac arrhythmias and highlight the need for sex specific analyses.
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BibTeX
@article{svenningsson2026γbutyrobetaine,
title = {{γ-Butyrobetaine, L-carnitine and acylcarnitines and their association with incident atrial fibrillation among men and women with suspected chronic coronary syndrome.}},
author = {Mads M Svenningsson and Ottar Nygård and Per M Ueland and Adrian McCann and Eva R Pedersen and Indu Dhar and Espen Bjørnestad and Dennis W Nilsen and Gard F T Svingen},
journal = {European heart journal open},
year = {2026},
month = sep,
doi = {10.1093/ehjopen/oeag163},
url = {https://europepmc.org/article/MED/42924194},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - γ-Butyrobetaine, L-carnitine and acylcarnitines and their association with incident atrial fibrillation among men and women with suspected chronic coronary syndrome.
AU - Mads M Svenningsson
AU - Ottar Nygård
AU - Per M Ueland
AU - Adrian McCann
AU - Eva R Pedersen
AU - Indu Dhar
AU - Espen Bjørnestad
AU - Dennis W Nilsen
AU - Gard F T Svingen
PY - 2026
DA - 2026/09/29
JO - European heart journal open
DO - 10.1093/ehjopen/oeag163
UR - https://europepmc.org/article/MED/42924194
AB - Aims Carnitine-metabolites play a key role in cell energy metabolism and have been implicated in the pathogenesis of atrial fibrillation (AF). However, any associations between L-carnitine and the precursor γ-butyrobetaine (γBB) with new-onset AF are not established. We therefore examined the relationship between serum γBB, L-carnitine and selected acylcarnitines with incident AF.Methods and results We studied 3815 patients who underwent coronary angiography due to suspected chronic coronary syndrome and followed up for incident CVD events, including new-onset AF. Risk associations between the biomarkers and incident AF were explored by logistic regression for the total population and stratified according to sex. The majority (71.6%) of the patients were men, the median age was 61 years. Over a median follow-up of 7.3 years, 412 (10.8%) were reported with new-onset AF. In a multivariate model higher serum γBB, L-carnitine and palmitoylcarnitine [OR per 1SD (95% CI): 1.15 (1.01-1.31), P = 0.04; 1.14 (1.01-1.27), P = 0.03 and 1.15 (1.03-1.28), P = 0.01] were associated with increased risk of incident AF. These associations were particularly stronger among women (P for interaction < 0.04, all).Conclusion In this large cohort of patients with suspected chronic coronary syndrome elevated circulating levels of γBB, L-carnitine and palmitoylcarnitine were associated with increased risk of incident AF, with stronger associations among women. Our results motivate further studies examining the relationship between carnitine metabolites and cardiac arrhythmias and highlight the need for sex specific analyses.
SN - 2752-4191
ER -