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Increased risk of atrial fibrillation in patients with inflammatory bowel disease: A nationwide population-based study

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World Journal of Gastroenterology 2019年第22期25卷 2788-2798页

作者： You-Jung Choi Eue-Keun Choi Kyung-Do Han jiesuck park Inki Moon Euijae Lee Won-Seok Choe So-Ryoung Lee Myung-Jin Cha Woo-Hyun Lim Seil Oh Department of Internal Medicine Seoul National University HospitalSeoul 03080South Korea Department of Biostatistics College of MedicineThe Catholic University of KoreaSeoul 03083South Korea Department of Internal Medicine Seoul National University Boramae Medical CenterSeoul 07061South Korea

BACKGROUND Inflammatory bowel disease (IBD), a chronic inflammatory disease of the gastrointestinal tract, could play a role in the pathophysiology of atrial fibrillation (AF). AIM To investigate the association between IBD and AF development. METHODS We performed a population-based cohort study using records in the Korean National Health Insurance Services database between 2010 and 2014. A total of 37696 patients with IBD (12349 with Crohn’s disease and 25397 with ulcerative colitis) were identified. The incidence rate of newly diagnosed AF in patients with IBD was compared with that in a 3 times larger cohort of 113088 age- and sex-matched controls without IBD. RESULTS During 4.9 ± 1.3 years of follow-up, 1120 patients newly diagnosed with AF (348 in the IBD group and 772 in controls) were identified. After adjustments using multivariable Cox proportional hazards, patients with IBD were at a 36%[95% confidence interval (CI) 20%-54%] higher risk of AF than controls. The association between IBD and the development of AF was stronger in younger than in older patients. Patients without cardiovascular risk factors showed a higher risk of AF primarily. Additionally, patients receiving immun-omodulators [Hazard ration (HR) 1.46, 95%CI 1.31-1.89], systemic corticosteroids (HR 1.37, 95%CI 1.10-1.71), or biologics agents (HR 2.38, 95%CI 1.51-3.75) were at higher risk of AF than patients without them. CONCLUSION IBD significantly increased the risk of AF, and the impact of IBD on developing AF was in patients with moderate to severe disease.

关键词： Atrial fibrillation Inflammatory bowel disease Colitis, Ulcerative Crohn's disease

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