Patients with asthma and a lack of asthma control had an increased risk for atrial fibrillation, according to a study published in JAMA Cardiology.
Aivaras Cepelis, MSci, of the department of public health and nursing at Norwegian University of Science and Technology in Trondheim, Norway, and colleagues analyzed data from 54,567 patients (53% women) from the HUNT2 and HUNT3 studies in Norway. Patients were excluded if they were diagnosed with AF at or before baseline.
Surveys were completed by patients to collect information on asthma, symptoms and medication use. Patients were then categorized by their asthma status (ever asthma, diagnosed asthma, active asthma) and asthma control (controlled, partly controlled, uncontrolled asthma).
ECGs were reviewed to determine whether a patient had AF based on the American College of Cardiology consensus guidelines. Other information that was reviewed in this study included anthropometrics, demographics, health, lifestyle factors, smoking status, education, physical activity, alcohol use, BMI and high-sensitivity C-reactive protein.
Of the patients in the study, 10.9% reported ever having asthma, 7.2% were diagnosed with asthma and 4.6% had active asthma. During a mean follow-up of 15.4 years, 3.8% of patients were diagnosed with AF.
Compared with patients without asthma, those with physician-diagnosed asthma had a 38% increased risk for AF (adjusted HR = 1.38; 95% CI, 1.18-1.61).
Asthma control and the risk for AF were associated in a dose-response manner. Patients with uncontrolled asthma had the highest risk for AF compared with the other groups (aHR = 1.74; 95% CI, 1.26-2.42).
The association of asthma with the risk for AF did not change after excluding patients who only had 5 years of follow-up information, those who were diagnosed with asthma at age 40 years or older and patients with comorbidities such as HF and MI.
“Given the high prevalence of asthma, clinicians should be aware of this connection and closely examine AF risk factors in this patient group,” Cepelis and colleagues wrote. “Further investigation is warranted into the underlying mechanisms of this association, including asthma medication use and inflammation, to clarify the causal pathways between asthma, asthma control and atrial fibrillation.” – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.