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Association Between Parkinson's Disease and Atrial Fibrillation: A Population-Based Study

Introduction: Autonomic nervous system (ANS) dysfunction contributes to several non-motor symptoms of Parkinson's disease (PD). In addition, ANS plays a role in the genesis and maintenance of atrial fibrillation (AF). This study investigated the temporal association between PD and AF. Methods:...

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Autores principales: Hong, Chien-Tai, Chan, Lung, Wu, Dean, Chen, Wan-Ting, Chien, Li-Nien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370731/
https://www.ncbi.nlm.nih.gov/pubmed/30804869
http://dx.doi.org/10.3389/fneur.2019.00022
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author Hong, Chien-Tai
Chan, Lung
Wu, Dean
Chen, Wan-Ting
Chien, Li-Nien
author_facet Hong, Chien-Tai
Chan, Lung
Wu, Dean
Chen, Wan-Ting
Chien, Li-Nien
author_sort Hong, Chien-Tai
collection PubMed
description Introduction: Autonomic nervous system (ANS) dysfunction contributes to several non-motor symptoms of Parkinson's disease (PD). In addition, ANS plays a role in the genesis and maintenance of atrial fibrillation (AF). This study investigated the temporal association between PD and AF. Methods: Data were obtained from the National Health Insurance Research Database of Taiwan. In total, 15,375 patients with newly diagnosed PD were matched with four controls each based on the propensity score. This study was bidirectional. A case-control study for the odds ratio (OR) of AF before PD and within 2 years of PD diagnosis was evaluated through conditional logistic regression. Furthermore, a cohort study on the subdistribution hazard ratio (SHR) for new-onset AF 2 years after PD diagnosis was evaluated using competing risk analysis. Results: In the case-control study, PD was found to be significantly comorbid with AF (adjusted OR: 1.15, 95% confidence interval [CI]: 1.04–1.28). Subgroup analysis demonstrated that this association consistently presented in the absence of confounding factors of AF. In the cohort study, people with PD were found to have a lower risk of AF (adjusted SHR: 0.92, 95% CI: 0.86–0.98). However, a consistent association was not observed between the confounding factors of AF and PD during the subgroup analysis. Conclusions: This study demonstrated that the premotor and early stages of PD were comorbid with AF, whereas the risk of AF was lower in the later stages. Thus, AF might be a premotor predictive biomarker and comorbidity of early PD.
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spelling pubmed-63707312019-02-25 Association Between Parkinson's Disease and Atrial Fibrillation: A Population-Based Study Hong, Chien-Tai Chan, Lung Wu, Dean Chen, Wan-Ting Chien, Li-Nien Front Neurol Neurology Introduction: Autonomic nervous system (ANS) dysfunction contributes to several non-motor symptoms of Parkinson's disease (PD). In addition, ANS plays a role in the genesis and maintenance of atrial fibrillation (AF). This study investigated the temporal association between PD and AF. Methods: Data were obtained from the National Health Insurance Research Database of Taiwan. In total, 15,375 patients with newly diagnosed PD were matched with four controls each based on the propensity score. This study was bidirectional. A case-control study for the odds ratio (OR) of AF before PD and within 2 years of PD diagnosis was evaluated through conditional logistic regression. Furthermore, a cohort study on the subdistribution hazard ratio (SHR) for new-onset AF 2 years after PD diagnosis was evaluated using competing risk analysis. Results: In the case-control study, PD was found to be significantly comorbid with AF (adjusted OR: 1.15, 95% confidence interval [CI]: 1.04–1.28). Subgroup analysis demonstrated that this association consistently presented in the absence of confounding factors of AF. In the cohort study, people with PD were found to have a lower risk of AF (adjusted SHR: 0.92, 95% CI: 0.86–0.98). However, a consistent association was not observed between the confounding factors of AF and PD during the subgroup analysis. Conclusions: This study demonstrated that the premotor and early stages of PD were comorbid with AF, whereas the risk of AF was lower in the later stages. Thus, AF might be a premotor predictive biomarker and comorbidity of early PD. Frontiers Media S.A. 2019-02-05 /pmc/articles/PMC6370731/ /pubmed/30804869 http://dx.doi.org/10.3389/fneur.2019.00022 Text en Copyright © 2019 Hong, Chan, Wu, Chen and Chien. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Hong, Chien-Tai
Chan, Lung
Wu, Dean
Chen, Wan-Ting
Chien, Li-Nien
Association Between Parkinson's Disease and Atrial Fibrillation: A Population-Based Study
title Association Between Parkinson's Disease and Atrial Fibrillation: A Population-Based Study
title_full Association Between Parkinson's Disease and Atrial Fibrillation: A Population-Based Study
title_fullStr Association Between Parkinson's Disease and Atrial Fibrillation: A Population-Based Study
title_full_unstemmed Association Between Parkinson's Disease and Atrial Fibrillation: A Population-Based Study
title_short Association Between Parkinson's Disease and Atrial Fibrillation: A Population-Based Study
title_sort association between parkinson's disease and atrial fibrillation: a population-based study
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370731/
https://www.ncbi.nlm.nih.gov/pubmed/30804869
http://dx.doi.org/10.3389/fneur.2019.00022
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