title: Association between panic disorder and risk of atrial fibrillation:a nationwide study.
abstract: OBJECTIVE
  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.
  
  
  RESULTS
  During 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.
  
  
  CONCLUSIONS
  PD 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.
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Ya-Fen
authors.initials: YF
authors.lastname: Cheng
authors.forename: Hsin-Bang
authors.initials: HB
authors.lastname: Leu
authors.forename: Ching-Chieh
authors.initials: CC
authors.lastname: Su
authors.forename: Chin-Chou
authors.initials: CC
authors.lastname: Huang
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Chiang
authors.forename: Po-Hsun
authors.initials: PH
authors.lastname: Huang
authors.forename: Chia-Min
authors.initials: CM
authors.lastname: Chung
authors.forename: Shing-Jong
authors.initials: SJ
authors.lastname: Lin
authors.forename: Jaw-Wen
authors.initials: JW
authors.lastname: Chen
authors.forename: Wan-Leong
authors.initials: WL
authors.lastname: Chan
mesh_terms: D000328:Adult; D000367:Age Factors; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000523:psychology*; D003324:Coronary Artery Disease / Q000453:epidemiology; D018572:Disease-Free Survival; D004812:Epidemiologic Methods; D005260:Female; D006349:Heart Valve Diseases / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000453:epidemiology / Q000523:psychology*; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology