Severe Atopic Dermatitis Associated With Increased Risk for Atrial Fibrillation

Patients with moderate to severe atopic dermatitis have an increased risk for atrial fibrillation (AF), according to study results published in Journal of the American Academy of Dermatology.

As systemic low-grade inflammation is a hallmark of atopic dermatitis and may contribute to an increased risk for AF, researchers aimed to study the relationship between atopic dermatitis and the development of AF using patient data obtained from the 35-year Danish National Patient Registry (DNPR) cohort study.

The DNPR was used to identify individuals who received a first-time hospital diagnosis of atopic dermatitis between 1977 and 2013. The Civil Registration System was used to obtain a comparison cohort of 10 individuals from the general population matched to each patient with atopic dermatitis based on sex and birth year.

Secondary diagnosis of AF was also obtained from the DNPR. To account for overlapping physiology, diagnosis of AF and flutter were both included. Potential risk factors for AF were also obtained from the DNPR and used in primary analysis as potential confounders.

A total of 13,144 patients (57% female) with atopic dermatitis were included in the analysis, with 124,487control patients. The median patient age was 19 years, with a median follow-up of 19.3 years. The cumulative incidence of AF during 35 years of follow-up in the atopic dermatitis cohort was 0.81%, compared with 0.67% in the comparison cohort (hazard ratio [HR], 1.2; 95% CI, 1.0-1.6). This increased risk was more pronounced in women (HR, 1.6) compared with men (HR, 1.0).

The researchers noted that a limitation of the study is the age of the patient population (<65 years), which is relatively low considering the typical age of onset for AF. In addition, the hospital-based diagnosis of atopic dermatitis limits interpretation of results to the most severe end of the disease spectrum.

“[P]atients with hospital-diagnosed (moderate-to-severe) atopic dermatitis have a 20% increased long-term risk of atrial fibrillation compared with the general population,” the researchers concluded. “Although the clinical implications are limited by a low absolute risk of atrial fibrillation, the typical early onset of atopic dermatitis may provide clinicians with a unique opportunity for promoting a heart healthy lifestyle to reduce risk for cardiovascular disease, including atrial fibrillation.”

Reference

Schmidt SAJ, Olsen M, Schmidt M, et al. Atopic dermatitis and risk of atrial fibrillation or flutter: a 35-year follow-up study [published online August 20, 2019]. J Amer Acad Dermatol. Doi: org/10.1016/j.jaad.2019

This article originally appeared on Dermatology Advisor