title: Risk of incident atrial fibrillation in patients with rheumatoid arthritis: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Patients with rheumatoid arthritis (RA) might be at an increased risk of developing atrial fibrillation (AF) as a result of deleterious effects of inflammatory cytokines on cardiomyocytes. This study aimed to comprehensively review all available evidence to further characterize this possible association.
  
  
  METHODS
  We conducted a systematic review and meta-analysis of cohort studies that reported relative risk, hazard ratio, incidence ratio or standardized incidence ratio with 95% confidence intervals comparing the risk of incidence of AF in patients with RA versus non-RA participants. Pooled risk ratio and 95% confidence interval were calculated using random-effect, generic inverse-variance methods of DerSimonian and Laird.
  
  
  RESULTS
  Three retrospective cohort studies with 39 912 cases of RA and 4 269 161 non-RA controls were included in the data analysis. The pooled risk ratio of subsequent development of AF in patients with RA versus controls was 1.29 (95% CI, 1.05-1.59). The statistical heterogeneity was moderate with an I2of 71%.
  
  
  CONCLUSIONS
  Our meta-analysis demonstrated a statistically significant increased risk of subsequent development of AF among patients with RA.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.|Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Patompong
authors.initials: P
authors.lastname: Ungprasert
authors.affiliation: Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Narat
authors.initials: N
authors.lastname: Srivali
authors.affiliation: Division ofNephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Wonngarm
authors.initials: W
authors.lastname: Kittanamongkolchai
mesh_terms: D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000453:epidemiology*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors
keywords: clinical aspects (rheumatoid arthritis); epidemiology (rheumatoid arthritis)