There is substantial literature to validate the role of inflammation and the innate immune system in developing myocardial infarction, cerebrovascular events, and heart failure. Now a recent study published by a group of researchers from the University Medical Center Rotterdam, Netherlands, has reported that various autoimmune diseases are linked to new-onset atrial fibrillation, especially in women.
The study evaluated the data of 494,072 participants (median age, 58 years; 54.8% women) obtained from the UK Biobank who were without atrial fibrillation at baseline. Follow-up conducted for a median of 12.8 years, identified 27,194 (5.5%) participants with new-onset atrial fibrillation. The study has noted that the following inflammatory diseases were associated with a large risk of atrial fibrillation: rheumatic fever without heart involvement (HR, 1.47; 95% CI, 1.26-1.72), Crohn disease (HR, 1.23; 95% CI, 1.05-1.45), ulcerative colitis (HR, 1.17; 95% CI, 1.06-1.31), rheumatoid arthritis (HR, 1.39; 95% CI, 1.28-1.51), polyarteritis nodosa (HR, 1.82; 95% CI, 1.04-3.09), SLE (HR, 1.82; 95% CI, 1.41-2.35), and systemic sclerosis (HR, 2.32; 95% CI, 1.57-3.44). In sex-stratified analyses, rheumatic fever without heart involvement, multiple sclerosis, Crohn disease, seropositive rheumatoid arthritis, psoriatic and enteropathic arthropathies, systemic sclerosis, and ankylosing spondylitis (HR, 1.53; 95% CI, 1.13-2.07) were found to be significantly associated with larger risk for atrial fibrillation in women.
A 2020 retrospective population‐based case-control study by Meduni et al. has reported a significant association of autoimmune vasculitis with atrial fibrillation, thereby suggesting one mechanism linking inflammation and autoimmunity to the pathogenesis of atrial fibrillation. The researchers have also noted that 5‐year survival was worse for patients with atrial fibrillation and autoimmune vasculitis when compared to those without autoimmune vasculitis or AF (44.7% versus 77.2%; P<0.001).
The present study further elaborates on the current knowledge of the pathophysiological differences in autoimmunity, and this may be beneficial in guiding future preventive strategies. However, further evidence is warranted for the corroboration of the present study findings and its clinical translation.
References
- Tilly MJ, Geurts S, Zhu F, Bos MM, Ikram MA, de Maat MPM, de Groot NMS, Kavousi M. Autoimmune diseases and new-onset atrial fibrillation: a UK Biobank study. Europace. 2022 Dec 2.
- Melduni RM, Cooper LT, Gersh BJ, Warrington KJ, Bailey KR, McEvoy MT, Kita H, Lee HC. Association of Autoimmune Vasculitis and Incident Atrial Fibrillation: A Population-Based Case-Control Study. J Am Heart Assoc. 2020 Sep 15;9(18):e015977.