Association Between Panic Disorder and Risk of Atrial Fibrillation: A Nationwide Study

Institute of BiomedicalSciences (C.-M.C.), Academia Sinica, Taipei, Taiwan
Psychosomatic Medicine (Impact Factor: 3.47). 10/2012; 75(1). DOI: 10.1097/PSY.0b013e318273393a
Source: PubMed


The aim of the present study was to investigate the association between panic disorder (PD) and atrial fibrillation (AF).Methods
We used a nationwide population-based data set from Taiwan. A total of 3888 patients with PD and without a diagnosis of AF from a sampled cohort data set of 1,000,000 were included in the study group. Ten people without PD and AF were selected for every 1 patient in the study group, matched by propensity score matching according to time of enrollment, age, sex, and comorbidities. We performed log-rank tests to analyze differences in accumulated AF-free survival rates between the two groups. Cox proportional hazard regressions were performed to evaluate the independent factors determining the longitudinal hazard of AF.ResultsDuring a maximal 7-year follow-up, 48 patients from the study group (1.2% of the patients with PD) and 358 from the control group (0.9% of the patients without PD) were newly diagnosed as having AF. Patients with PD had a significantly higher incidence of AF (hazard ratio [HR] = 1.54 [1.14-2.09]; log-rank test, p = .004). After Cox model adjustment for risk factors and comorbidities, PD (HR = 1.73, 95% confidence interval [CI] = 1.26-2.37), age (HR = 1.07, 95% CI = 1.06-1.08), male sex (HR = 1.26, 95% CI = 1.03-1.55), hypertension (HR = 2.00, 95% CI = 1.55-2.56), history of coronary artery disease (HR = 1.45, 95% CI = 1.15-1.82), congestive heart failure (HR = 2.46; 95% CI, 1.84-3.30), and valvular heart disease (HR = 2.83, 95% CI = 1.85-4.42) were independently associated with increased risk of AF.ConclusionsPD is independently associated with higher incidence of AF to be diagnosed in the future. Larger prospective studies or meta-analysis are suggested to confirm the findings.

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Available from: Ching-Chieh Su
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    • "In the only available cross-sectional study, no cases of current PD were found in a small sample of patients with clinically significant arrhythmias (Ehlers et al., 2000). However, a large nationwide , population-based prospective study showed that patients with PD had a significantly higher risk of future AF compared with participants without PD (Cheng et al., 2013). Although in this study the control group was not screened for other psychiatric conditions, this finding suggests an involvement of PD in the occurrence of AF. "
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