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Atopic dermatitis and risk of atrial fibrillation or flutter: A 35-year follow-up study - 05/02/20

Doi : 10.1016/j.jaad.2019.08.039 
Sigrun A.J. Schmidt, PhD a, b, , Morten Olsen, PhD a, c, Morten Schmidt, PhD a, d, Christian Vestergaard, DMSc b, Sinéad M. Langan, PhD e, f, Mette S. Deleuran, DMSc b, Jette L. Riis, PhD b
a Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark 
b Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark 
c Department of Radiology, Aarhus University Hospital, Aarhus, Denmark 
d Department of Cardiology, Regional Hospital West Jutland, Herning, Denmark 
e Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom 
f Health Data Research UK, London, United Kingdom 

Correspondence to: Sigrun A.J. Schmidt, PhD, Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, DK-8200, Aarhus N.Department of Clinical EpidemiologyAarhus University HospitalOlof Palmes Allé 43-45Aarhus NDK-8200
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 05 February 2020
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Abstract

Background

Atopic dermatitis is characterized by chronic inflammation, which is a risk factor for atrial fibrillation.

Objective

To examine the association between hospital-diagnosed atopic dermatitis and atrial fibrillation.

Methods

Using linked population-based Danish registries, we identified persons with an inpatient or outpatient hospital diagnosis of atopic dermatitis during 1977-2013 and a comparison cohort individually matched to the atopic dermatitis cohort. We followed cohorts until death, emigration, atrial fibrillation diagnosis, or end of study (January 1, 2013). We compared 35-year risk of atrial fibrillation and estimated hazard ratios with 95% confidence intervals using Cox regression, adjusting for birth year and sex. We validated 100 atopic dermatitis diagnoses from a dermatologic department through medical record review.

Results

We included 13,126 persons with atopic dermatitis and 124,211 comparators and followed them for a median of 19.3 years. The 35-year risk of atrial fibrillation was 0.81% and 0.67%, respectively. The positive predictive value of atopic dermatitis diagnoses was 99%. The hazard ratio was 1.2 (95% confidence interval 1.0-1.6) and remained increased after adjusting for various atrial fibrillation risk factors.

Limitations

Analyses were limited to persons with moderate-to-severe atopic dermatitis, and we had no lifestyle data.

Conclusion

Patients with hospital-diagnosed atopic dermatitis have a 20% increased long-term risk of atrial fibrillation, but the absolute risk remains low.

Le texte complet de cet article est disponible en PDF.

Key words : atopic dermatitis, atrial fibrillation, atrial flutter, cohort study, risk factors, validation

Abbreviations used : CI, DNPR, HR


Plan


 Funding sources: Supported by a Wellcome Senior Clinical Fellowship in Science (205039/Z/16/Z to Dr Langan) and the Health Data Research UK (grant no. LOND1 to Dr Langan), which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), and British Heart Foundation and Wellcome Trust.
 Conflicts of interest: None disclosed.
 IRB Approval: The study was approved by the Danish Data Protection Agency (record no. 2013-41-2237; 2016-051-000001). Danish legislation does not require approval by an ethical review board or informed consent from patients for registry-based studies. The Danish Patient Safety Authority approved access to medical records for the validation of diagnoses (record no. 3-3013-1526/1/). The study protocol is available from the corresponding author upon request.
 Reprints not available from the authors.


© 2019  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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