Bacani A Kirstin, Crowson Cynthia S, Roger Véronique L, Gabriel Sherine E, Matteson Eric L
Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA ; Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.
Biomed Res Int. 2015;2015:809514. doi: 10.1155/2015/809514. Epub 2015 Mar 1.
To investigate the incidence of atrial fibrillation (AF) among patients with rheumatoid arthritis (RA) compared to the general population.
A population-based inception cohort of Olmsted County, Minnesota, residents with incident RA in 1980-2007 and a cohort of non-RA subjects from the same population base were assembled and followed until 12/31/2008. The occurrence of AF was ascertained by medical record review.
The study included 813 patients with RA and 813 non-RA subjects (mean age 55.9 (SD:15.7) years, 68% women in both cohorts). The prevalence of AF was similar in the RA and non-RA cohorts at RA incidence/index date (4% versus 3%; P = 0.51). The cumulative incidence of AF during follow-up was higher among patients with RA compared to non-RA subjects (18.3% versus 16.3% at 20 years; P = 0.048). This difference persisted after adjustment for age, sex, calendar year, smoking, and hypertension (hazard ratio: 1.46; 95% CI: 1.07, 2.00). There was no evidence of a differential impact of AF on mortality in patients with RA compared to non-RA subjects (hazard ratio 2.5 versus 2.8; interaction P = 0.31).
The incidence of AF is increased in patients with RA, even after adjustment for AF risk factors. AF related mortality risk did not differ between patients with and without RA.
与普通人群相比，调查类风湿关节炎（RA）患者中心房颤动（AF）的发生率。
收集了明尼苏达州奥尔姆斯特德县1980 - 2007年新发RA患者的基于人群的起始队列以及来自相同人群基础的非RA受试者队列，并随访至2008年12月31日。通过病历审查确定AF的发生情况。
该研究纳入了813例RA患者和813例非RA受试者（平均年龄55.9（标准差：15.7）岁，两个队列中女性均占68%）。在RA发病/索引日期时，RA队列和非RA队列中AF的患病率相似（4%对3%；P = 0.51）。随访期间，RA患者中AF的累积发生率高于非RA受试者（20年时为18.3%对16.3%；P = 0.048）。在对年龄、性别、日历年份、吸烟和高血压进行调整后，这种差异仍然存在（风险比：1.46；95%置信区间：1.07, 2.00）。没有证据表明AF对RA患者死亡率的影响与非RA受试者不同（风险比2.5对2.8；交互作用P = 0.31）。
即使在对AF风险因素进行调整后，RA患者中AF的发生率仍会增加。有RA和无RA患者之间与AF相关的死亡风险没有差异。
