Atopic dermatitis and risk of atrial fibrillation or flutter: A 35-year follow-up study.
J Am Acad Dermatol 2020;
83:1616-1624. [PMID:
31442537 PMCID:
PMC7704103 DOI:
10.1016/j.jaad.2019.08.039]
[Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 07/26/2019] [Accepted: 08/14/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND
Atopic dermatitis is characterized by chronic inflammation, which is a risk factor for atrial fibrillation.
OBJECTIVE
To examine the association between hospital-diagnosed atopic dermatitis and atrial fibrillation.
METHODS
Using linked population-based Danish registries, we identified persons with an inpatient or outpatient hospital diagnosis of atopic dermatitis during 1977-2013 and a comparison cohort individually matched to the atopic dermatitis cohort. We followed cohorts until death, emigration, atrial fibrillation diagnosis, or end of study (January 1, 2013). We compared 35-year risk of atrial fibrillation and estimated hazard ratios with 95% confidence intervals using Cox regression, adjusting for birth year and sex. We validated 100 atopic dermatitis diagnoses from a dermatologic department through medical record review.
RESULTS
We included 13,126 persons with atopic dermatitis and 124,211 comparators and followed them for a median of 19.3 years. The 35-year risk of atrial fibrillation was 0.81% and 0.67%, respectively. The positive predictive value of atopic dermatitis diagnoses was 99%. The hazard ratio was 1.2 (95% confidence interval 1.0-1.6) and remained increased after adjusting for various atrial fibrillation risk factors.
LIMITATIONS
Analyses were limited to persons with moderate-to-severe atopic dermatitis, and we had no lifestyle data.
CONCLUSION
Patients with hospital-diagnosed atopic dermatitis have a 20% increased long-term risk of atrial fibrillation, but the absolute risk remains low.
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