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Prevalence and the clinical outcome of atrial fibrillation in patients with Autoimmune Rheumatic Disease

Authors
 Yong-Soo Baek  ;  Tae-Hoon Kim  ;  Jae-Sun Uhm  ;  Jong-Yun Kim  ;  Hui-Nam Pak  ;  Moon-Hyoung Lee  ;  Boyoung Joung 
Citation
 INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol.214 : 4-9, 2016 
Journal Title
 INTERNATIONAL JOURNAL OF CARDIOLOGY 
ISSN
 0167-5273 
Issue Date
2016
MeSH
Adult ; Age Factors ; Aged ; Atrial Fibrillation/epidemiology* ; Atrial Fibrillation/metabolism ; Autoimmune Diseases/epidemiology* ; Autoimmune Diseases/metabolism ; C-Reactive Protein/metabolism ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Rheumatic Diseases/epidemiology* ; Rheumatic Diseases/metabolism ; Risk Factors ; Tertiary Care Centers/statistics & numerical data
Keywords
Atrial fibrillation ; Autoimmune rheumatic disease ; Death ; Inflammation ; Stroke
Abstract
BACKGROUND: Systemic inflammation plays an important role in the pathogenesis of atrial fibrillation (AF). However, little evidence exists whether the risk of AF is increased in autoimmune rheumatic disease (ARD). METHODS: In 20,772 consecutive ARD patients (mean age 42±17years, 13,683 female) in a tertiary hospital from 2005 to 2015, AF prevalence, comorbidities and cardiovascular (CV) outcomes were evaluated. RESULTS: AF was observed in 235 (1.1%) patients. The mean duration to AF diagnoses was 5.9±2.4years. Compared with patients without AF, AF patients were older, and had a higher CRP level (5.1±0.7 vs. 2.7±0.2mg/L, p=0.01), higher incidence of hypertension, heart failure and coronary artery disease. The AF prevalence was higher in inflammatory myositis (3.5%) and systemic sclerosis (2.3%) than that in other ARDs (all p<0.05). In the multivariate analysis, the independent predictors of AF were an older age (HR 1.05, 95% CI: 1.04-1.06, p=0.01), hypertension (HR 2.28, 95% CI: 1.70-3.06, p<0.001), high CRP levels (HR 1.75, 95% CI: 1.07-2.86, p=0.04), and heart failure (HR 11.96, 95% CI: 8.13-17.60, p=0.03). During a mean follow-up period of 6.8±4.5years, ARD patients with AF had a higher all cause death (16.5% vs. 2.1%, p<0.001) and incidence of strokes (1.9% vs. 0.4%, p=0.001) than non-AF patients. CONCLUSIONS: The incidence of AF in ARD was affected by specific disease and an inflammatory status manifested by the CRP level. AF in ARD was related to a higher mortality and strokes mandating meticulous follow-up.
Full Text
http://www.sciencedirect.com/science/article/pii/S0167527316305058
DOI
10.1016/j.ijcard.2016.03.083
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jong Youn(김종윤) ORCID logo https://orcid.org/0000-0001-7040-8771
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Lee, Moon Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146910
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