You-Jung Choi1, Eue-Keun Choi2, Kyung-Do Han3, Soonil Kwon1, Seo-Young Lee1, Seokhun Yang1, Euijae Lee4, So-Ryoung Lee1, Myung-Jin Cha1, Seil Oh1. 1. Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 2. Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: choiek17@snu.ac.kr. 3. Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea. 4. Department of Cardiology, Sejong General Hospital, Bucheon-si, Kyung-gi, Republic of Korea.
Abstract
BACKGROUND: Despite a sharp increase in the global prevalence of allergy over the past decade, the relation between multiple atopic conditions and atrial fibrillation (AF) has not been fully elucidated. OBJECTIVE: To determine whether there is an association between atopic diseases and AF and to examine the effect of multiple atopic diseases on the incidence of AF. METHODS: This retrospective population-based study used the database from the 2009 National Health Insurance Services-Health Screening Cohort in Korea. A total of 6,748,564 subjects without a previous history of AF were included in the final analysis and observed until 2017. The atopic triad included asthma, allergic rhinitis, and atopic dermatitis. A total of 1,168,196 subjects (17.3%) with at least one atopic disease were classified as the atopic group. The primary outcome was new-onset AF. RESULTS: During a median 7.2 ± 1.0 years of follow-up, 136,253 subjects were given the new diagnosis of AF (30,300 in the atopic group and 105,953 in the nonatopic group). The incidence of AF was 3.63/1000 person-years in the atopic group and 2.64/1000 person-years in the nonatopic group. The risk for AF showed a positive correlation with the number of diseases in the atopic triad (adjusted hazard ratio [aHR], 95% confidence interval [CI]: one disease: aHR = 1.15, CI, 1.14-1.17; two diseases: aHR = 1.34, CI, 1.31-1.38; and three diseases: aHR = 1.35, CI, 1.11-1.66; P for trend < .001). CONCLUSIONS: The atopic triad of asthma, allergic rhinitis, and atopic dermatitis was associated with an increased risk for AF. Moreover, multiple atopic conditions have a higher risk for AF.
BACKGROUND: Despite a sharp increase in the global prevalence of allergy over the past decade, the relation between multiple atopic conditions and atrial fibrillation (AF) has not been fully elucidated. OBJECTIVE: To determine whether there is an association between atopic diseases and AF and to examine the effect of multiple atopic diseases on the incidence of AF. METHODS: This retrospective population-based study used the database from the 2009 National Health Insurance Services-Health Screening Cohort in Korea. A total of 6,748,564 subjects without a previous history of AF were included in the final analysis and observed until 2017. The atopic triad included asthma, allergic rhinitis, and atopic dermatitis. A total of 1,168,196 subjects (17.3%) with at least one atopic disease were classified as the atopic group. The primary outcome was new-onset AF. RESULTS: During a median 7.2 ± 1.0 years of follow-up, 136,253 subjects were given the new diagnosis of AF (30,300 in the atopic group and 105,953 in the nonatopic group). The incidence of AF was 3.63/1000 person-years in the atopic group and 2.64/1000 person-years in the nonatopic group. The risk for AF showed a positive correlation with the number of diseases in the atopic triad (adjusted hazard ratio [aHR], 95% confidence interval [CI]: one disease: aHR = 1.15, CI, 1.14-1.17; two diseases: aHR = 1.34, CI, 1.31-1.38; and three diseases: aHR = 1.35, CI, 1.11-1.66; P for trend < .001). CONCLUSIONS: The atopic triad of asthma, allergic rhinitis, and atopic dermatitis was associated with an increased risk for AF. Moreover, multiple atopic conditions have a higher risk for AF.