Department of Cardiology Karolinska University Hospital, Stockholm, Sweden.
Heart and Lung Disease Unit, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2024 May 31;19(5):e0304624. doi: 10.1371/journal.pone.0304624. eCollection 2024.
Gastroesophageal reflux disease (GERD) may influence the risk of atrial fibrillation (AF). We investigated the association between symptoms of GERD and AF in the Trøndelag Health Study (HUNT).
The study cohort comprised 34,120 adult men and women initially free of AF with information on GERD symptoms. Participants were followed from the baseline clinical examination (1 October 2006 to 30 June 2008) to March 31, 2018.
During a median follow-up of 8.9 years, 1,221 cases of AF were diagnosed. When looking at the whole population, participants with much GERD symptoms did not have an increased risk of AF (HR: 1.01; CI: 95%, 0.82 to 1.24) while participants with little GERD symptoms had a 14% lower risk of AF compared those with no GERD symptoms (HR: 0.86; CI: 95%, 0.76 to 0.97). Among younger participants (<40 years of age), the risk of AF had a trend towards increased risk with increasing symptom load of GERD (little GERD symptoms, HR: 3.09; CI: 95%, 0.74 to 12.94 and much GERD symptoms, HR: 5.40; 95% CI: 0.82 to 35.58). Among older participants (≥65 years of age), we saw a slightly reduced risk of AF in participants with little symptoms (HR: 0.84; CI: 0.72 to 0.97) and no association among those with much GERD symptoms (HR: 1.06; 95% CI: 0.82 to 1.36).
We did not find support for a clinically important association between symptoms of GERD and AF across all age groups but for some younger people, GERD might play a role in the development of AF. However, our estimates for this age group were very imprecise and larger studies including younger individuals are warranted.
胃食管反流病(GERD)可能会影响心房颤动(AF)的风险。我们在特隆赫姆健康研究(HUNT)中调查了 GERD 症状与 AF 之间的关联。
该研究队列包括 34120 名最初无 AF 且有 GERD 症状信息的成年男女。参与者从基线临床检查(2006 年 10 月 1 日至 2008 年 6 月 30 日)开始随访,随访至 2018 年 3 月 31 日。
在中位数为 8.9 年的随访期间,诊断出 1221 例 AF。在观察整个人群时,有大量 GERD 症状的参与者发生 AF 的风险没有增加(HR:1.01;95%CI:0.82 至 1.24),而有少量 GERD 症状的参与者发生 AF 的风险比没有 GERD 症状的参与者低 14%(HR:0.86;95%CI:0.76 至 0.97)。在年轻参与者(<40 岁)中,随着 GERD 症状负荷的增加,AF 的风险呈上升趋势(少量 GERD 症状,HR:3.09;95%CI:0.74 至 12.94;大量 GERD 症状,HR:5.40;95%CI:0.82 至 35.58)。在老年参与者(≥65 岁)中,我们发现有少量症状的参与者发生 AF 的风险略有降低(HR:0.84;95%CI:0.72 至 0.97),而大量 GERD 症状的参与者则没有关联(HR:1.06;95%CI:0.82 至 1.36)。
我们没有发现 GERD 症状与所有年龄段的 AF 之间存在临床重要关联的证据,但对于一些年轻人来说,GERD 可能在 AF 的发展中起作用。然而,我们对这一年龄组的估计非常不准确,需要进行包括更多年轻人的更大规模研究。