Gastroesophageal reflux disease and atrial fibrillation: a nationwide population-based study.
OBJECTIVE
Precise mechanisms of atrial fibrillation (AF) are uncertain, but their association with esophageal disorders has been recently proposed. The association between gastroesophageal reflux disease (GERD), the most common gastroesophageal disorder, and AF remains undetermined. We therefore aimed to investigate the association between GERD and later development of AF.


RESULTS
Patients with GERD were identified from the 1,000,000-person cohort dataset sampled from the Taiwan National Health Insurance database. The study cohort comprised 29,688 newly diagnosed adult GERD patients; 29,597 randomly selected age-, gender-, comobidity-matched subjects comprised the comparison cohort. Cox proportional hazard regressions were performed as a means of comparing the AF-free survival rate for the two cohorts. During a maximum three years of follow-up, a total of 351 patients experienced AF, including 184 (0.62%) patients in the GERD cohort and 167 (0.56%) in the control group. The log-rank test showed that patients with GERD had significantly higher incidence of AF than those without GERD (p = 0.024). After Cox proportional hazard regression model analysis, GERD was independently associated with the increased risk of AF (hazard ratio, 1.31; 95% confidence interval, 1.06-1.61, p = 0.013).


CONCLUSIONS
GERD was independently associated with an increased risk of future AF in a nationwide population-based cohort.
Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
Chin-Chou
CC
Huang
Wan-Leong
WL
Chan
Jiing-Chyuan
JC
Luo
Yu-Chun
YC
Chen
Tzeng-Ji
TJ
Chen
Chia-Min
CM
Chung
Po-Hsun
PH
Huang
Shing-Jong
SJ
Lin
Jaw-Wen
JW
Chen
Hsin-Bang
HB
Leu
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology