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Autoimmune diseases and new-onset atrial fibrillation: a UK Biobank study

AIMS: The underlying mechanisms of atrial fibrillation (AF) are largely unknown. Inflammation may underlie atrial remodelling. Autoimmune diseases, related to increased systemic inflammation, may therefore be associated with new-onset AF. METHODS AND RESULTS: Participants from the population-based U...

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Autores principales: Tilly, Martijn J, Geurts, Sven, Zhu, Fang, Bos, Maxime M, Ikram, M Arfan, de Maat, Moniek P M, de Groot, Natasja M S, Kavousi, Maryam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10062304/
https://www.ncbi.nlm.nih.gov/pubmed/36546587
http://dx.doi.org/10.1093/europace/euac244
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author Tilly, Martijn J
Geurts, Sven
Zhu, Fang
Bos, Maxime M
Ikram, M Arfan
de Maat, Moniek P M
de Groot, Natasja M S
Kavousi, Maryam
author_facet Tilly, Martijn J
Geurts, Sven
Zhu, Fang
Bos, Maxime M
Ikram, M Arfan
de Maat, Moniek P M
de Groot, Natasja M S
Kavousi, Maryam
author_sort Tilly, Martijn J
collection PubMed
description AIMS: The underlying mechanisms of atrial fibrillation (AF) are largely unknown. Inflammation may underlie atrial remodelling. Autoimmune diseases, related to increased systemic inflammation, may therefore be associated with new-onset AF. METHODS AND RESULTS: Participants from the population-based UK Biobank were screened for rheumatic fever, gastrointestinal autoimmune diseases, autoimmune diseases targeting the musculoskeletal system and connective tissues, and neurological autoimmune diseases. Between 2006 and 2022, participants were followed for incident AF. Cox proportional hazards regression analyses were performed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) to quantify associations. 494 072 participants free from AF were included (median age 58.0 years, 54.8% women). After a median of 12.8 years, 27 194 (5.5%) participants were diagnosed with new-onset AF. Rheumatic fever without heart involvement (HR, 95% CI: 1.47, 1.26–1.72), Crohn’s disease (1.23, 1.05–1.45), ulcerative colitis (1.17, 1.06–1.31), rheumatoid arthritis (1.39, 1.28–1.51), polyarteritis nodosa (1.82, 1.04–3.09), systemic lupus erythematosus (1.82, 1.41–2.35), and systemic sclerosis (2.32, 1.57–3.44) were associated with a larger AF risk. In sex-stratified analyses, rheumatic fever without heart involvement, multiple sclerosis, Crohn’s disease, seropositive rheumatoid arthritis, psoriatic and enteropathic arthropathies, systemic sclerosis and ankylosing spondylitis were associated with larger AF risk in women, whereas only men showed a larger AF risk associated with ulcerative colitis. CONCLUSIONS: Various autoimmune diseases are associated with new-onset AF, more distinct in women. Our findings elaborate on the pathophysiological differences in autoimmunity and AF risk between men and women.
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spelling pubmed-100623042023-03-31 Autoimmune diseases and new-onset atrial fibrillation: a UK Biobank study Tilly, Martijn J Geurts, Sven Zhu, Fang Bos, Maxime M Ikram, M Arfan de Maat, Moniek P M de Groot, Natasja M S Kavousi, Maryam Europace Clinical Research AIMS: The underlying mechanisms of atrial fibrillation (AF) are largely unknown. Inflammation may underlie atrial remodelling. Autoimmune diseases, related to increased systemic inflammation, may therefore be associated with new-onset AF. METHODS AND RESULTS: Participants from the population-based UK Biobank were screened for rheumatic fever, gastrointestinal autoimmune diseases, autoimmune diseases targeting the musculoskeletal system and connective tissues, and neurological autoimmune diseases. Between 2006 and 2022, participants were followed for incident AF. Cox proportional hazards regression analyses were performed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) to quantify associations. 494 072 participants free from AF were included (median age 58.0 years, 54.8% women). After a median of 12.8 years, 27 194 (5.5%) participants were diagnosed with new-onset AF. Rheumatic fever without heart involvement (HR, 95% CI: 1.47, 1.26–1.72), Crohn’s disease (1.23, 1.05–1.45), ulcerative colitis (1.17, 1.06–1.31), rheumatoid arthritis (1.39, 1.28–1.51), polyarteritis nodosa (1.82, 1.04–3.09), systemic lupus erythematosus (1.82, 1.41–2.35), and systemic sclerosis (2.32, 1.57–3.44) were associated with a larger AF risk. In sex-stratified analyses, rheumatic fever without heart involvement, multiple sclerosis, Crohn’s disease, seropositive rheumatoid arthritis, psoriatic and enteropathic arthropathies, systemic sclerosis and ankylosing spondylitis were associated with larger AF risk in women, whereas only men showed a larger AF risk associated with ulcerative colitis. CONCLUSIONS: Various autoimmune diseases are associated with new-onset AF, more distinct in women. Our findings elaborate on the pathophysiological differences in autoimmunity and AF risk between men and women. Oxford University Press 2022-12-22 /pmc/articles/PMC10062304/ /pubmed/36546587 http://dx.doi.org/10.1093/europace/euac244 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Clinical Research
Tilly, Martijn J
Geurts, Sven
Zhu, Fang
Bos, Maxime M
Ikram, M Arfan
de Maat, Moniek P M
de Groot, Natasja M S
Kavousi, Maryam
Autoimmune diseases and new-onset atrial fibrillation: a UK Biobank study
title Autoimmune diseases and new-onset atrial fibrillation: a UK Biobank study
title_full Autoimmune diseases and new-onset atrial fibrillation: a UK Biobank study
title_fullStr Autoimmune diseases and new-onset atrial fibrillation: a UK Biobank study
title_full_unstemmed Autoimmune diseases and new-onset atrial fibrillation: a UK Biobank study
title_short Autoimmune diseases and new-onset atrial fibrillation: a UK Biobank study
title_sort autoimmune diseases and new-onset atrial fibrillation: a uk biobank study
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10062304/
https://www.ncbi.nlm.nih.gov/pubmed/36546587
http://dx.doi.org/10.1093/europace/euac244
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