Increased Risk of Atrial Fibrillation in Patients with Atopic Triad: A Nationwide Population-Based Study.

Abstract Background Despite a sharp increase in the global prevalence of allergy over the past decade, the relationship between multiple atopic conditions and atrial fibrillation (AF) has not been fully elucidated. Objective To determine whether there is an association between atopic diseases and AF and to examine the effect of multiple atopic diseases on the incidence of AF. Methods This retrospective population-based study used the database from the 2009 National Health Insurance Services-Health Screening Cohort in Korea. A total of 6,748,564‬ subjects with no previous history of AF were included in the final analysis and followed up until 2017. The atopic triad included asthma, allergic rhinitis, and atopic dermatitis. A total of 1,168,196‬ (17.3%) subjects had at least one atopic disease and were classified as the atopic group. The primary outcome was new-onset AF. Results During 7.2 ± 1.0 years of follow-up, 136,253‬ subjects were newly diagnosed with AF (30,300 in the atopic group and 105,953 in the non-atopic group). The incidence of AF was 3.63 per 1,000 person-years in the atopic group and 2.64 per 1,000 person-years in the non-atopic group. The risk of AF showed a positive correlation with the number of diseases in the atopic triad (adjusted hazard ratio, 95% confidence interval; one, 1.15, 1.14–1.17; two, 1.34, 1.31–1.38; and three, 1.35, 1.11–1.66, P for trend Conclusion The atopic triad—asthma, allergic rhinitis, and atopic dermatitis—was associated with an increased risk of AF. Moreover, multiple atopic conditions have a higher risk of AF.