title: Predictors of incident atrial fibrillation and influence of medications: a retrospective case-control study.
abstract: BACKGROUND
  Atrial fibrillation (AF) is a common condition, associated with raised mortality and risk of major morbidity, and is predicted to increase due to an aging population.
  
  
  OBJECTIVE
  To update earlier research of AF predictors using UK data.
  
  
  METHODS
  Case-control analysis of adults aged 18 years and older with a diagnosis of AF in practices registered with the General Practice Research Database (GPRD) in the UK.
  
  
  METHODS
  Using the GPRD, a case.control analysis was performed using logistic regression to compare 55,412 incident AF cases to 216,400 controls, for medical history and prior use of drugs. The association between time since start of diagnosis or drug use and AF risk was summarised using Spline regression.
  
  
  RESULTS
  The following were confirmed as risk factors for AF: heart failure (risk ratio [RR] 2.91 [95% CI = 2.59 to 3.27]); ischaemic heart disease (IHD) (RR 2.00 [95% CI = 1.78 to 2.24]); hypertension (RR 2.60 [95% CI = 2.32 to 2.92]); hyperthyroidism (RR 1.56 [95% CI = 1.39 to 1.75]); being a heavy drinker (RR 1.43 [95% CI = 1.27 to 1.60]); cerebrovascular accident (RR 1.48 [95% CI = 1.32 to 1.66]); and obesity (body mass index ≥30 kg/m(2) RR 1.29 [95% CI = 1.15 to 1.45]). Current use of oral glucocorticoids (RR 1.62 [95% CI = 1.44 to 1.82]) and of beta-2 agonists (RR 1.30 [95% CI = 1.16 to 1.46]) were identified as significant risk factors, and statins (RR 0.82 [95% CI = 0.73 to 0.92]) as a significant protective factor. No effect was found for current use of bisphosphonates (RR 0.95 [95% CI = 0.85 to 1.07]), renin.angiotensin.aldosterone system (RAAS) agents (RR 1.04 [95% CI = 0.93 to 1.17]), or xanthine derivatives (RR 1.09 [95% CI = 0.97 to 1.22]). Spline regression analysis found the effect of heart failure, IHD, use of oral glucocorticoids, and use of statins on the likelihood of developing AF was sustained over a number of years.
  
  
  CONCLUSIONS
  These findings update the risk factors that are associated with AF, and confirm the protective properties of statins and the risks of beta-2 agonists in developing AF, but not the supposed protective qualities of glucocorticoids and RAAS agents.
authors.affiliation: Department of Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, UK. j.a.hodgkinson@bham.ac.uk
authors.forename: James A
authors.initials: JA
authors.lastname: Hodgkinson
authors.forename: Clare J
authors.initials: CJ
authors.lastname: Taylor
authors.forename: F D Richard
authors.initials: FD
authors.lastname: Hobbs
mesh_terms: D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D016022:Case-Control Studies; D005260:Female; D006333:Heart Failure / Q000150:complications; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006973:Hypertension / Q000150:complications; D006980:Hyperthyroidism / Q000150:complications; D008019:Life Style; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications; D009765:Obesity / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors