title: Prevalence and the clinical outcome of atrial fibrillation in patients with Autoimmune Rheumatic Disease.
abstract: BACKGROUND
  Systemic inflammation plays an important role in the pathogenesis of atrial fibrillation (AF). However, little evidence exists whether the risk of AF is increased in autoimmune rheumatic disease (ARD).
  
  
  METHODS
  In 20,772 consecutive ARD patients (mean age 42±17years, 13,683 female) in a tertiary hospital from 2005 to 2015, AF prevalence, comorbidities and cardiovascular (CV) outcomes were evaluated.
  
  
  RESULTS
  AF was observed in 235 (1.1%) patients. The mean duration to AF diagnoses was 5.9±2.4years. Compared with patients without AF, AF patients were older, and had a higher CRP level (5.1±0.7 vs. 2.7±0.2mg/L, p=0.01), higher incidence of hypertension, heart failure and coronary artery disease. The AF prevalence was higher in inflammatory myositis (3.5%) and systemic sclerosis (2.3%) than that in other ARDs (all p<0.05). In the multivariate analysis, the independent predictors of AF were an older age (HR 1.05, 95% CI: 1.04-1.06, p=0.01), hypertension (HR 2.28, 95% CI: 1.70-3.06, p<0.001), high CRP levels (HR 1.75, 95% CI: 1.07-2.86, p=0.04), and heart failure (HR 11.96, 95% CI: 8.13-17.60, p=0.03). During a mean follow-up period of 6.8±4.5years, ARD patients with AF had a higher all cause death (16.5% vs. 2.1%, p<0.001) and incidence of strokes (1.9% vs. 0.4%, p=0.001) than non-AF patients.
  
  
  CONCLUSIONS
  The incidence of AF in ARD was affected by specific disease and an inflammatory status manifested by the CRP level. AF in ARD was related to a higher mortality and strokes mandating meticulous follow-up.
authors.affiliation: Division of Cardiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Yong-Soo
authors.initials: YS
authors.lastname: Baek
authors.affiliation: Division of Cardiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jae-Sun
authors.initials: JS
authors.lastname: Uhm
authors.affiliation: Division of Cardiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jong-Yun
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hui-Nam
authors.initials: HN
authors.lastname: Pak
authors.affiliation: Division of Cardiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Moon-Hyoung
authors.initials: MH
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: cby6908@yuhs.ac.
authors.forename: Boyoung
authors.initials: B
authors.lastname: Joung
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000378:metabolism; D001327:Autoimmune Diseases / Q000453:epidemiology* / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000453:epidemiology* / Q000378:metabolism; D012307:Risk Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data
chemical_list: D002097:C-Reactive Protein
keywords: Atrial fibrillation; Autoimmune rheumatic disease; Death; Inflammation; Stroke