Retrospective Cohort Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2021; 9(14): 3252-3264
Published online May 16, 2021. doi: 10.12998/wjcc.v9.i14.3252
Burden of atrial fibrillation in patients with rheumatic diseases
Muhammad Zubair Khan, Kirtenkumar Patel, Krunalkumar A Patel, Rajkumar Doshi, Vraj Shah, Devina Adalja, Zainulabedin Waqar, Sona Franklin, Neelesh Gupta, Muhammad Hamdan Gul, Shruti Jesani, Steven Kutalek, Vincent Figueredo
Muhammad Zubair Khan, Krunalkumar A Patel, Sona Franklin, Department of Internal Medicine, St. Mary Medical Center, Langhorne, PA 19047, United States
Kirtenkumar Patel, Division of Cardiology, North Shore University Hospital, Manhasset, NY 11030, United States
Rajkumar Doshi, Department of Internal Medicine, University of Nevada Reno School of Medicine, Reno, NV 89502, United States
Vraj Shah, Division of Cardiology, Medical College of Baroda, Baroda 390001, India
Devina Adalja, Department of Internal Medicine, GMERS Gotri Medical College, Vadodara 390021, India
Zainulabedin Waqar, Department of Internal Medicine, Mercy St. Vincent Medical Center, Toledo, OH 43608, United States
Neelesh Gupta, Department of Internal Medicine, Nazareth Hospital, Philadelphia, PA 19115, United States
Muhammad Hamdan Gul, Department of Internal Medicine, Saint Joseph Hospital, Chicago, IL 60657, United States
Shruti Jesani, Department of Internal Medicine, Trinitas Regional Medical Center, Elizabeth, NJ 07202, United States
Steven Kutalek, Vincent Figueredo, Department of Cardiology, St. Mary Medical Center, Langhorne, PA 19047, United States
Author contributions: Khan MZ, Patel K, Patel KA, Kutalek S, Figueredo V designed the research study; Doshi R, Patel K, Shah V, Waqar Z performed the research; Adalja D, Franklin S, Gupta N, Gul MH, and Jesani S analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: The study cohort was derived from a de-identified and publicly available database; hence, the study was considered exempt from formal approval of the Institutional review board.
Informed consent statement: We used Nationwide Inpatient Sample database for our study. Our database does not contain information of patient’s identity. So, the informed consent is not required.
Conflict-of-interest statement: All other authors have nothing to disclose.
Data sharing statement: Statistical code and dataset available from the corresponding author.
STROBE statement: The authors have read the STROBE Statement-a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vincent Figueredo, FACC, FAHA, Assistant Professor, Department of Cardiology, St. Mary Medical Center, 1203 Langhorne-Newtown Road, Suite 320, Langhorne, PA 19047, United States. vincent.figueredo@stmaryhealthcare.org
Received: January 7, 2021
Peer-review started: January 7, 2021
First decision: January 18, 2021
Revised: February 6, 2021
Accepted: March 19, 2021
Article in press: March 19, 2021
Published online: May 16, 2021
Processing time: 111 Days and 17.3 Hours
ARTICLE HIGHLIGHTS
Research background

Atrial fibrillation (AF) can be induced by systemic inflammation in certain diseases such as rheumatic diseases (RD). A relationship between rheumatoid arthritis and AF was evaluated in the Danish cohort study, while other studies have shown a lack of relationship between RA and AF.

Research motivation

Arrhythmia should be excluded in RD patients with cardiac risk factors. If the patient develops any concerning cardiac symptoms, RD patients should be monitored for arrhythmia using cardiac monitors.

Research objectives

The purpose of this study was to determine the association of AF among hospitalized RD patients and to determine morbidity and mortality associated with AF in hospitalized patients with RD.

Research methods

National Inpatient Sample database from October 2015 to December 2017 was used for the current study. International classification of disease, 10th revision, clinical modification codes were used to identify diagnosis RD and AF patients. The analysis was conducted using statistical analysis system statistical software version 9.4. Both univariate and multivariable regression analysis was used to identify the association between AF and RD.

Research results

Higher AF prevalence was found in RD patients. After adjusting the risk factors using multivariate regression analysis, the strongest association of AF was found with gout, vasculitis and polymyalgia. Conversely, enteropathic arthropathy, scleroderma, ankylosing spondylitis, and Sjorgen’s syndrome had decreased association with AF.

Research conclusions

The study showed a higher association of AF with gout and vasculitis. Overall mortality, length of stay and hospitalization cost was higher among RD patients with AF.

Research perspectives

Further randomized controlled trial should be directed to evaluate long-term outcomes of arrhythmias in RD patients.