Atopic Diseases and Their Impact on Atrial Fibrillation Risk

In a systematic review and meta-analysis, published in Frontiers in Cardiovascular Medicine, researchers explored associations between atopic diseases and risk of atrial fibrillation (AF) based on findings from population-based studies. Based on their analysis, the study authors concluded that patients with atopic diseases—particularly those with asthma—had a higher risk of developing AF.

The review selected 6 cohort studies and 2 case-control studies published to the PubMed and Embase databases by November 2021. Researchers used random- and fixed-effects models to assess the hazard ratio (HR) and odds ratio (OR) of effects of atopic conditions and I2 and Cochran Q tests to evaluate heterogeneity between the study populations.

The 6 cohort studies included 1,452,112 patients with atopic diseases and 7,373,745 comparators, while the 2 case-control studies tracked the history of asthma in 8,869 patients with AF and 112,505 comparators.

Asthma, Allergic Rhinitis, and Atopic Diseases Increase Risk of AF

According to the authors, data of the 6 cohort studies suggested that atopic diseases significantly increased the risk for AF (pooled HR, 1.26; 95% confidence interval [CI], 1.14-1.39). However, the effect of atopic diseases in the 2 case-control studies was not statistically significant (pooled OR, 1.04; 95% CI, 0.74-1.46).

Specifically, subgroup analyses in the 6 cohort studies revealed that asthma (pooled HR, 1.41; 95% CI, 1.25-1.58), allergic rhinitis (pooled HR, 1.12; 95% CI, 1.10-1.14), and atopic dermatitis (pooled HR, 1.06; 95% CI, 1.01-1.12) all potentially increased the risk of developing AF.

The study’s authors noted that their ability to perform further subgroup analyses was limited to a degree by the small number of studies which met their inclusion criteria. Additionally, they acknowledged that the definitions of allergic diseases and AF lacked specificity across the studies—including no distinctions between paroxysmal and persistent AF.

Regardless, the authors suggested that asthma, allergic rhinitis, and atopic dermatitis all potentially increased the risk of AF. They felt further high-quality studies are warranted to confirm the potential association bet ween atopic diseases and AF, “with particular attention to whether the increased risk of different types of AF is related to the type, severity, and treatment of atopic diseases.”

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