Increased Risk of Atrial Fibrillation in Patients with Atopic Triad: A Nationwide Population-Based Study

BACKGROUND: Despite a sharp increase in the global prevalence of allergy over the past decade, the relation between multiple atopic conditions and atrial fibrillation (AF) has not been fully elucidated. OBJECTIVE: To determine whether there is an association between atopic diseases and AF and to examine the effect of multiple atopic diseases on the incidence of AF. METHODS: This retrospective population-based study used the database from the 2009 National Health Insurance ServicesHealth Screening Cohort in Korea. A total of 6,748,564 subjects without a previous history of AF were included in the final analysis and observed until 2017. The atopic triad included asthma, allergic rhinitis, and atopic dermatitis. A total of 1,168,196 subjects (17.3%) with at least one atopic disease were classified as the atopic group. The primary outcome was newonset AF. RESULTS: During a median 7.2 - 1.0 years of follow-up, 136,253 subjects were given the new diagnosis of AF (30,300 in the atopic group and 105,953 in the nonatopic group). The incidence of AF was 3.63/1000 person-years in the atopic group and 2.64/1000 person-years in the nonatopic group. The risk for AF showed a positive correlation with the number of diseases in the atopic triad (adjusted hazard ratio [aHR], 95% confidence interval [CI]: one disease: aHR [1.15, CI, 1.14-1.17; two diseases: aHR [1.34, CI, 1.31-1.38; and three diseases: aHR [1.35, CI, 1.11-1.66; P for trend <.001). CONCLUSIONS: The atopic triad of asthma, allergic rhinitis, and atopic dermatitis was associated with an increased risk for AF. Moreover, multiple atopic conditions have a higher risk for AF. (C) 2021 American Academy of Allergy, Asthma & Immunology