Article

Glucocorticoid use and risk of atrial fibrillation or flutter: a population-based, case-control study.

Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Alle 43-45, DK-8200 Aarhus N, Denmark.
Archives of internal medicine (Impact Factor: 13.25). 10/2009; 169(18):1677-83. DOI: 10.1001/archinternmed.2009.297
Source: PubMed

ABSTRACT Glucocorticoid use is associated with increased risk of myocardial infarction, stroke, and heart failure, but data are limited on the risk of atrial fibrillation or flutter. We examined whether glucocorticoid use is associated with the risk of atrial fibrillation or flutter.
For this population-based, case-control study, we identified all patients with a first hospital diagnosis of atrial fibrillation or flutter from January 1, 1999, through December 31, 2005, in Northern Denmark (population, 1.7 million). For each case we selected 10 population controls matched by age and sex. We obtained data on glucocorticoid prescriptions within 60 days (current users) or longer before the index date (former users), comorbidity, and medications from medical databases. We used conditional logistic regression to compute odds ratios (ORs), controlling for potential confounders.
Among 20,221 patients with atrial fibrillation or flutter, 1288 (6.4%) were current glucocorticoid users and 2375 (11.7%) were former users. Among 202,130 population controls, 5245 (2.6%) were current glucocorticoid users and 19 940 (9.9%) were former users. Current glucocorticoid use was associated with an increased risk of atrial fibrillation or flutter compared with never use (adjusted OR, 1.92; 95% confidence interval [CI], 1.79-2.06). Among new glucocorticoid users, the adjusted OR was 3.62 (95% CI, 3.11-4.22) and among long-term users it was 1.66 (95% CI, 1.53-1.80). The increased risk remained robust in patients with and without pulmonary and cardiovascular diseases. Former glucocorticoid use was not associated with increased risk (adjusted OR, 1.00; 95% CI, 0.96-1.06).
Current glucocorticoid use was associated with an almost 2-fold increased risk of atrial fibrillation or flutter.

0 Followers
 · 
103 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The methodological advances in epidemiology have facilitated the use of the Danish Civil Registration System (CRS) in ways not previously described systematically. We reviewed the CRS and its use as a research tool in epidemiology. We obtained information from the Danish Law on Civil Registration and the Central Office of Civil Registration, and used existing literature to provide illustrative examples of its use. The CRS is an administrative register established on April 2, 1968. It contains individual-level information on all persons residing in Denmark (and Greenland as of May 1, 1972). By January 2014, the CRS had cumulatively registered 9.5 million individuals and more than 400 million person-years of follow-up. A unique ten-digit Civil Personal Register number assigned to all persons in the CRS allows for technically easy, cost-effective, and unambiguous individual-level record linkage of Danish registers. Daily updated information on migration and vital status allows for nationwide cohort studies with virtually complete long-term follow-up on emigration and death. The CRS facilitates sampling of general population comparison cohorts, controls in case-control studies, family cohorts, and target groups in population surveys. The data in the CRS are virtually complete, have high accuracy, and can be retrieved for research purposes while protecting the anonymity of Danish residents. In conclusion, the CRS is a key tool for epidemiological research in Denmark.
    European Journal of Epidemiology 06/2014; 29(8). DOI:10.1007/s10654-014-9930-3 · 5.15 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Asthma and atrial fibrillation (AF) have been reported to be related to an increased risk of cardiovascular events. However, the relationship between asthma and AF has not been fully elucidated. The purpose of this study was to examine the association between asthma and AF risk.
    International Journal of Cardiology 08/2014; 176(2). DOI:10.1016/j.ijcard.2014.07.087 · 6.18 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Arthritis is a chronic inflammatory condition commonly associated with mobility restriction and reduced activity. To date, the extent to which arthritis is an independent risk factor for stroke is unclear, and important, in light of an aging population. The purpose of this study was to (i) quantify the cross-sectional association between stroke and arthritis and (ii) to determine whether the relationship differed in physically active and inactivemiddle-aged and older adults. Data was derived from the 2010 Canadian Community Health Survey (N = 47 188; ≥30 y). Multivariable logistic regression was used to estimate the association between arthritis and stroke in models adjusted for age, physical activity (PA), and demographic factors. Overall, individuals with arthritis were 4 times more likely to report a history of stroke (OR = 3.8, 95% CI = 3.06-4.68), whereas those who were engaged in at least moderate PA (≥ 1.5 kcal/kg/day) were less than half as likely (0.45, 0.92-0.62). This effect was moderated by age, as younger (30-65 y: 3.27, 2.22-4.83) but not older adults (>65 y: 1.04, 0.8-1.35) with arthritis had elevated odds of stroke. Both physical inactivity and arthritis are associated with higher odds of stroke, effects of which are the strongest amongst 30-65 year olds.
    04/2014; 2014:651921. DOI:10.1155/2014/651921

Full-text (3 Sources)

Download
71 Downloads
Available from
Jun 1, 2014