ScholarWorks@성균관대학교

초록

Background: The link between rheumatoid arthritis (RA) and atrial fibrillation (AF) has received less attention. Objective: This study aimed to examine the association between RA and incident AF in a nationwide cohort, with particular focus on differences according to serostatus—seropositive RA (SPRA) and seronegative RA (SNRA). We explored the potential influence of biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) use as a secondary objective. Methods: This retrospective cohort study used the National Health Insurance Service database to include participants who were first diagnosed with RA between 2010 and 2017. Matched non-RA controls were selected by age and sex (1:3 ratio). Participants were followed from 1 year after the index date (to mitigate surveillance bias) until December 31, 2020. Results: A total of 48,885 patients with RA (34,699 SPRA, 14,186 SNRA) and 146,655 matched controls were included. Patients with RA had a significantly higher risk of AF than non-RA controls (adjusted hazard ratio [aHR] 1.55, 95% confidence interval 1.46–1.65). Both patients with SPRA and SNRA had a higher AF risk than non-RA controls (aHR 1.63 in SPRA, 1.37 in SNRA). Patients with SPRA had a higher risk compared with those with SNRA (aHR 1.19, 95% confidence interval 1.02–6.34). The use of biologic disease-modifying antirheumatic drugs was associated with a slightly higher risk of AF, while targeted synthetic disease-modifying antirheumatic drug use led to risk reduction, but was not statistically significant. Conclusion: This study shows that both patients with SPRA and SNRA are at a significantly greater risk for AF compared with non-RA controls, with patients with SPRA at the highest risk.

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