Validating a Predictive Risk Model for Child Abuse and Neglect With Adolescent Outcomes.

Atrial fibrillation (AF), recognized as the most prevalent cardiac arrhythmia impacting over 33 million individuals globally [], is a supraventricular tachyarrhythmia characterized by rapid and disorganized atrial electrical activity, which leads to ineffective atrial contraction and irregular ventricular rhythm. Despite advances in catheter ablation and surgical techniques such as the Cox-Maze IV procedure [, ], and emerging biomarkers like exosomes [], the pathogenesis of AF remains incompletely understood. This condition is linked to a notable rise in both morbidity and mortality rates []. Due to the global aging trend, the prevalence of AF is predicted to increase further, thereby amplifying the related socioeconomic burden []. Research has indicated that inflammation, genetic factors, and dietary habits are risk factors contributing to AF []. However, these factors do not fully explain the pathogenesis of AF. Given its increasing prevalence, further exploration of the risk factors for AF is necessary. Chronic pain, defined as pain that persists or recurs for more than three months according to the International Association for the Study of Pain (IASP) [], ranks among the most widespread conditions worldwide. Contemporary research is increasingly regarding chronic pain not merely as a symptom but as a disease [, ]. It imposes a significant personal and economic burden, affecting more than 30% of people worldwide []. Previous studies have established a link between chronic pain and cardiovascular disease (CVD) []. A Mendelian randomization study demonstrated that experiencing chronic pain in multiple sites elevates the risk of developing coronary artery disease []. Another study indicated that self-reported pain was associated with a previous diagnosis of coronary heart disease []. Research has also demonstrated a link between chronic pain and variability in heart rate [–]. Given the interaction between chronic pain and inflammation [], which can contribute to the development of AF, it is plausible to consider a connection between chronic pain and AF. To our knowledge, no prospective cohort study has investigated the association between chronic pain and the risk of developing AF. Genetic risk factors are regarded as significant contributors to the development of AF []. Over the past few decades, over 160 genes have been linked to the occurrence of AF []. Syed S Mahmood et al. confirmed through the Framingham Heart Study that genetic factors are an important contributor to AF []. The study by Jason D Roberts et al. showed that current research has made great strides in unravelling the complex genetic basis of AF, and that polygenic risk score (PRS) targeting AF has become increasingly valued because of its large effect size and relevance to a wide range of populations []. PRS has proven effective in quantifying the cumulative impact of multiple risk-associated genetic variants. However, it is still unclear whether polygenic risk for AF and chronic pain jointly affect AF.